J Gynecol Oncol.  2009 Mar;20(1):39-43. 10.3802/jgo.2009.20.1.39.

Association between bacterial vaginosis and cervical intraepithelial neoplasia

• Nam KH
• Kim YT
• Kim SR
• Kim SW
• Kim JW
• Lee MK
• Nam EJ
• Jung YW

• KMID: 2055647
• DOI: http://doi.org/10.3802/jgo.2009.20.1.39

Abstract

OBJECTIVE
The aim of this study was to determine whether the presence of bacterial vaginosis (BV) is associated with cervical intraepithelial neoplasia (CIN) and human papilloma virus (HPV) infection.
METHODS
A total of 588 women who had abnormal Pap smears and had finally undergone loop electrosurgical excision procedure (LEEP) in our institute from September 2002 to May 2006 were selected. The screening tests for BV were done in 552 of the 588, and BV was diagnosed if three of the following four findings were satisfied: presence of abnormal discharge, vaginal pH>4.5, presence of clue cells, positive amine or whiff test. Five hundred and five patients had HPV typing tests by the HPV DNA chip. Forty two patients diagnosed with invasive cancer were excluded from this study. CIN was subdivided into low-grade CIN (CIN I) and high-grade CIN (CIN II/III) groups.
RESULTS
There was no statistically significant difference in patient characteristics between BV-present and BV-absent group. The incidence of CIN was significantly higher in the BV-present group (p=0.043), however, no statistical significance of BV on CIN was observed on multivariate analysis. HPV infection showed no significant relationship with BV. BV with or without HPV infection did not influence the incidence of CIN, regardless of the severity.
CONCLUSION
There was significant correlation between BV and the presence of CIN, regardless of the severity of CIN. In addition, there was no significant association between the presence of BV and HPV infection.

Keyword

Bacterial vaginosis; Cervical intraepithelial neoplasia; Human papilloma virus

MeSH Terms

Cervical Intraepithelial Neoplasia
Female
Humans
Incidence
Mass Screening
Multivariate Analysis
Oligonucleotide Array Sequence Analysis
Papilloma
Vaginal Discharge
Vaginosis, Bacterial
Viruses

Figure

• 

  Fig. 1 Diagnosis of bacterial vaginosis (A) presence of vaginal secretions coating gray and thinly the vaginal wall, (B) vaginal pH>4.5, (C) presence of clue cells on microscopic examination of vaginal smear, (D) positive amine or whiff test.

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