Microecology is an emerging discipline in recent years. The female reproductive tract is an important microecological region, and its microecological environment can directly affect women’s cervical health. This meta-analysis aimed to analyze the effects of vaginal microecology on Human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN). PubMed and Web of Science were systematically searched for eligible publications from January 2000 to December 2017. Articles were selected on the basis of specific inclusion and exclusion criteria. The design and quality of all studies were evaluated using the Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) with a 95% confidence interval (95% CI) were calculated. Thirteen eligible studies were selected to evaluate the association of vaginal microecology with HPV infection and CIN. The factors related to HPV infection were bacterial vaginosis (BV) (OR 2.57, 95% CI 1.78–3.71, P<0.05), Candida albicans (VVC) (OR 0.63, 95% CI 0.49–0.82, P < 0.05), Chlamydia trachomatis (CT) (OR 3.16, 95% CI 2.55–3.90, P < 0.05), and Ureaplasma urealyticum (UU) (OR 1.35, 95% CI 1.20–1.51, P < 0.05). BV was also related to CIN (OR 1.56, 95% CI 1.21–2.00, P < 0.05). This meta-analysis of available literature suggested an intimate association of vaginal microecology and HPV infection with CIN. BV, CT and UU were associated to increased HPV infection, VVC was associated to decreased HPV infection, Lactobacillus is not associated to increased HPV infection, BV was associated to increased CIN development risk. Further large-scale studies are needed to confirm our findings.

中文翻译：

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阴道微生态、人乳头瘤病毒感染与宫颈上皮内瘤变关系的Meta分析


微生态学是近年来兴起的一门新兴学科。女性生殖道是重要的微生态区域，其微生态环境可直接影响女性宫颈健康。本荟萃分析旨在分析阴道微生态对人乳头瘤病毒（HPV）感染和宫颈上皮内瘤变（CIN）的影响。从 2000 年 1 月到 2017 年 12 月，系统地检索了 PubMed 和 Web of Science 中符合条件的出版物。文章是根据具体的纳入和排除标准进行选择的。所有研究的设计和质量均使用纽卡斯尔-渥太华量表（NOS）进行评估。计算了具有 95% 置信区间 (95% CI) 的优势比 (OR)。选择了 13 项符合条件的研究来评估阴道微生态与 HPV 感染和 CIN 的关联。与HPV感染相关的因素为细菌性阴道病（BV）（OR 2.57，95% CI 1.78-3.71，P<0.05）、白色念珠菌（VVC）（OR 0.63，95% CI 0.49-0.82，P< 0.05） ）、沙眼衣原体 (CT)（OR 3.16，95% CI 2.55–3.90，P < 0.05）和解脲脲原体 (UU)（OR 1.35，95% CI 1.20–1.51，P < 0.05）。 BV 也与 CIN 相关（OR 1.56，95% CI 1.21–2.00，P < 0.05）。对现有文献的荟萃分析表明，阴道微生态和 HPV 感染与 CIN 密切相关。 BV、CT 和 UU 与 HPV 感染增加相关，VVC 与 HPV 感染减少相关，乳酸菌与 HPV 感染增加无关，BV 与 CIN 发生风险增加相关。需要进一步的大规模研究来证实我们的发现。