国际生殖健康/计划生育杂志

国际生殖健康/计划生育杂志 ›› 2025, Vol. 44 ›› Issue (2): 116-120.doi: 10.12280/gjszjk.20240554

• 论著 • 上一篇    下一篇

妇科肿瘤患者阴道微生态特征分析

赵淑婷, 周芷伊, 许波群()   

  1. 210003 南京医科大学第二附属医院妇产科
  • 收稿日期:2024-11-19 出版日期:2025-03-15 发布日期:2025-03-10
  • 通讯作者: 许波群，E-mail：boqun_xu@njmu.edu.cn

Analysis of Vaginal Microecological Characteristics in Gynecological Tumor Patients

ZHAO Shu-ting, ZHOU Zhi-yi, XU Bo-qun()   

  1. Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210003, China
  • Received:2024-11-19 Published:2025-03-15 Online:2025-03-10
  • Contact: XU bo-qun, E-mail: boqun_xu@njmu.edu.cn

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摘要：

目的： 探讨妇科良恶性肿瘤的阴道微生态特征和差异。方法： 回顾性分析2022年6月—2024年6月152例患者的临床资料，分为恶性肿瘤组（n=58）和良性肿瘤组（n=94），同时选取同期进行常规体检的健康女性80例作为健康对照组。比较3组患者的一般资料、阴道分泌物的乳杆菌丰度、菌群多样性、菌群密集度、pH值和阴道清洁度等微生态特征。结果： 3组阴道分泌物中乳杆菌丰度减少、小杆菌丰度增多、白细胞增多、线索细胞阳性、孢子阳性、芽生孢子阳性、阴道清洁度异常、pH值>4.5、微生态失衡、菌群多样性异常、菌群密集度异常、Nugent评分异常和Donders评分异常患者占比差异有统计学意义（均P<0.05）。组间两两比较结果显示，上述阴道微生态指标在良性肿瘤组和恶性肿瘤组的患者占比均高于健康对照组（均P<0.016 7），恶性肿瘤组乳杆菌丰度减少、线索细胞阳性、pH值>4.5、微生态失衡、菌群多样性异常和菌群密集度异常患者占比高于良性肿瘤组（均P<0.016 7）。结论： 妇科肿瘤患者阴道微生态失调，恶性肿瘤患者失衡更严重，微生态失衡程度可能是妇科肿瘤早期诊断及良恶性鉴别的潜在标志。

关键词: 生殖器肿瘤, 女（雌）性, 乳杆菌属, 阴道, 微生物群, 生态失调

Abstract:

Obejective: To investigate the vaginal microbiome characteristics and differences between benign and malignant gynecological tumors. Methods: The clinical data of 152 patients were retrospectively analyzed from June 2022 to June 2024. The patients were divide into the malignant tumor group (n=58) and the benign tumor group (n=94). Additionally, 80 healthy women who underwent routine physical examinations during the same period were selected as the control group. The general information, lactobacillus abundance, microbial diversity, microbial density, pH value, and vaginal cleanliness of the microecological characteristics wre compared among the three groups. Results: There were significant differences in the proportions of patients with decreased lactic acid bacteria abundance, increased small coccoid bacteria abundance, increased leukocytes, positive clue cells, positive spores, positive budding spores, abnormal vaginal cleanliness, pH>4.5, microbial imbalance, abnormal bacterial diversity, and abnormal bacterial density, as well as abnormal Nugent scores and Donders scores (all P<0.05). The pairwise comparison of results between groups showed that the proportions of patients with the aforementioned vaginal microecological indicators were higher in both the benign tumor group and the malignant tumor group, when compared to the control group (all P<0.016 7). The proportions of patients with decreased lactobacillus abundance, positive clue cells, pH>4.5, microbial imbalance, abnormal bacterial diversity, and abnormal bacterial density in the malignant tumor group were higher than those in the benign tumor group (all P<0.016 7). Conclusions: Vaginal microbiome dysregulation is prevalent in patients with gynecological neoplasms, with a pronounced imbalance being more common in cases of malignant tumors. The severity of microbiome dysbiosis may serve as a potential biomarker for the early diagnosis and differential diagnosis of benign versus malignant gynecological neoplasms.

Key words: Genital neoplasms, female, Lactobacillus, Vagina, Microbiota, Dysbiosis