Analysis of vaginal microecological characteristics after cone biopsy in patients with high-risk HPV infection ac-companied by high-grade squamous intraepithelial lesions
Objective To analyze the vaginal microecological characteristics following cone biopsy in patients with high-grade squamous intraepithelial lesions due to high-risk HPV infection,providing a basis for assessing vaginal microecology and recovery post-surgery.Methods A total of 160 patients who underwent cone biopsy due to high-risk HPV infection resulting in high-grade squamous intraepithelial lesions were selected as the observation group.Preopera-tive and postoperative vaginal microecological characteristics were collected and analyzed,alongside patient age,HPV sub-type,postoperative follow-up time,and reinfection rates.Additionally,200 healthy women undergoing gynecological ex-aminations in the same period served as the healthy control group.The vaginal microecological conditions and changes in bacterial flora among the three groups were compared.Results The rate of vaginal microecological imbalance in cone bi-opsy patients preoperatively was 81.88％,decreasing to 60.63％postoperatively,which was significantly different from the healthy control group(P＜0.01).Statistically significant differences were also noted in the proportions of Gram-pos-itive bacilli,vaginal pH,leukocyte counts,and cleanliness across the three groups(P＜0.01).Most patients in the cone biopsy group were aged 31-50 years(70.63％),with vaginal microecological balance rates correlating with age;patients over 51 years had a higher imbalance rate(x2=11.157,P＜0.05).The analysis of preoperative HPV subtypes revealed that subtype 16 was the most common;however,there was no significant difference in the imbalance rate among different HPV subtypes(x2=2.404,P＞0.05).Of the 85 patients tested postoperatively for HPV,the reinfection rate was 34.12％(29/85),with no significant difference in microecological characteristics between reinfected and negative cases(x2=0.03,P＞0.05).The highest number of follow-ups occurred within one month post-surgery(36.87％),where the imbalance rate was notably high(79.66％).With time,the imbalance rate decreased.No significant differences were observed in bacterial density,diversity,leukocyte counts,or vulvovaginal candidiasis(VVC)across different follow-up times(P＞0.05);however,there were significant differences in the proportions of Gram-positive bacilli,vaginal pH,cleanliness,bacterial vaginosis(BV),and atrophic vaginitis(AV)(P＜0.05).Conclusion Older patients undergoing cone biopsy may require more time for vaginal microecological balance to be restored post-surgery.Over time,most pa-tients show a tendency towards recovery to a balanced state,and monitoring vaginal microecology post-cone biopsy is beneficial for understanding patient recovery.
high-risk human papillomavirushigh-grade squamous intraepithelial lesionscone biopsyvagi-nal microecology
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