Relationship between vaginal microecology and HPV16/18 infection and establishment of clinical prediction model
Objective To study the relationship between vaginal microecology and human papillomavirus(HPV)16/18 infection,and to evaluate the clinical applicability of vaginal microecology in predicting the diagnosis of HPV16/18 infection.Methods A total of 2 000 women who underwent vaginal microecology and cervical HPV detection from March 2022 to March 2023 were selected as the research objects.The high-risk factors of HPV16/18 infection in vaginal microecology were analyzed,and the clinical prediction model for the risk of HPV16/18 infection was established and evaluated.Results There were 241 cases in positive group and 1 759 cases in HPV negative group;there were statistically significant differences in the Lactobacilli deficiency,bacterial vaginitis(BV),aerobic vaginitis(AV)incidences and the positive rates of β-glucuronidase(GUS),sialidase(SNA)and leukocyte esterase(LE)between the two groups(P<0.05).The Lactobacilli deficiency,BV,AV and GUS,SNA,LE positive were risk factors for HPV16/18 infection(P<0.05).Three prediction models of Logistic regression,decision tree and random forest were established,among which BV and AV were important predictors;Logistic regression model showed the highest accuracy in predicting the risk of HPV16/18 infection;the calibration curve of the Logistic regression model had a good correlation with the prediction probability,and the decision curve analysis showed that the prediction model had good clinical applicability.Conclusion Vaginal microecology imbalance is closely associated with cervical HPV16/18 infection,especially BV and AV.The Logistic regression prediction model of HPV16/18 infection risk based on six factors of Lactobacilli deficiency,BV,AV,SNA,LE and GUS has better accuracy and clinical applicability.
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