阴道微生态与HR-HPV感染及宫颈癌前病变的相关性研究
Correlation between Vaginal Microbiota and HR-HPV Infection and Cervical Precancer

众所周知，宫颈癌是与乳腺癌、卵巢癌并列的女性三大死亡元凶之一，据世界卫生组织国际癌症研究署(IARC)发布的2020年全球最新癌症负担数据，2020年全球新增宫颈癌60万例，新增宫颈癌死亡34万例。数据有限，暂无最新的统计数据。随着HPV疫苗的全世界范围内的普及，宫颈癌发病率显著降低，在BJM上发表的研究论文显示：接种年龄越小，疫苗有效性越高。虽然对于HPV疫苗早期接种对于预防宫颈癌发病的有效性不可忽视，但是否有其他更为简洁的方式来预防宫颈癌的发生我们尚未可知。目前，科学家们也在从宫颈癌的致病因子、发病途径以及分子生物层次探究预防宫颈癌的新生之路，通过大量阅读文献，整理研究数据，不难发现宫颈癌的直接致病因子是人乳头瘤病毒，而间接发病因子主要包括性生活过早、性伴侣过多、个人饮食卫生习惯、生活环境，特别提到的一点是，过去不曾被研究者们所注意的阴道微生物也与宫颈癌的发病密切相关。女性阴道微生态的重要性已经被大多数学者所熟知，例如：阴道微生态与不良妊娠结局、子宫内膜异位症、卵巢癌以及泌尿生殖道炎症等疾病密切相关。当下HPV引起宫颈病变进而发展为宫颈癌的机制是当今各大学者研究热点，但在此过程中阴道微生态所起的重要角色却鲜为人知。本篇综述旨在突出与整理HPV感染后人体阴道微观世界发生的显著变化，以及对于宫颈癌前病变后续治疗相关生物技术的一些最新进展，从而了解其与宿主的相互作用和癌症进展。通过大量收集和浏览最新的文献资料和数据，揭示阴道微生态在HPV感染过程中发挥的重要作用若揭开阴道微生态在宫颈癌发病过程中的神秘面纱，未来就可以通过改善阴道微生态从而预防宫颈癌以及对早期宫颈病变进行早期干预，同样可以减轻HPV相关疾病负担。
According to the latest global cancer burden data released by the World Health Organization’s International Agency for Research on Cancer (IARC) in 2020, there were 600,000 new cases of cervical cancer and 340,000 new deaths from cervical cancer in the world in 2020. Data is limited and the latest statistics are not available. With the worldwide spread of HPV vaccines, the incidence of cervical cancer has decreased significantly, and a research paper published in BJM shows that the younger the age of vaccination, the more effective the vaccine is. Although the effectiveness of early HPV vaccination in preventing the onset of cervical cancer cannot be ignored, it is not yet known whether there are other more concise ways to prevent cervical cancer. At present, scientists are also exploring the new way of preventing cervical cancer from the pathogenic factors, pathways and molecular biological levels of cervical cancer, through a large number of reading literature, sorting out research data, it is not difficult to find that the direct pathogenic factor of cervical cancer is human papillomavirus, and the indirect pathogenic factors mainly include premature sexual life, too many sexual partners, personal dietary hygiene habits, living environment, especially mentioned that the vaginal microorganism that has not been noticed by researchers in the past is also closely related to the incidence of cervical cancer. The importance of the female vaginal microbiota has been well known by most scholars, for example, the vaginal microbiota is closely related to adverse pregnancy outcomes, endometriosis, ovarian cancer, and genitourinary tract inflammation. At present, the mechanism