Relation between aerobic vaginitis and histologically proven cervical intraepithelial neoplasia

Persistent human papillomavirus (HPV) infection is a prerequisite for the development of cervical intraepithelial neoplasia (CIN) and cervical cancer. Still factors promoting this progression are not fully explored. The association between different vaginal microflora changes and CIN has been debated in the literature in the recent years. Although, not much is known about a possible role of aerobic vaginitis in the development of cervical dysplasia. The aim of this study was to analyse the relation between aerobic vaginitis and histological finding of CIN. In the time from July 2016 until December 2019 110 consecutive patients with abnormal cervical cytology referred for colposcopy to Riga East Clinical University Hospital (RECUH) Outpatient department were included in the study group. 118 women who came for a gynaecological check-up were chosen as controls. Material from upper vaginal fornix was taken for wet-mount microscopy. Colposcopy was performed in all participants; cervical biopsies were taken from all study group subjects and in case of visual suspicion for CIN in the control group. Histological analysis was performed in RECUH Pathology Center. Statistical analysis was done with Microsoft Excel 2010 and IBM SPSS 20.0. In the study group there were 31 (28.2%) cases of CIN1, 57 (51.8%) cases of CIN2, 21 (19.1%) cases of CIN3 and 1 (0.9%) cervical cancer case. Any AV associated microflora changes (35/110 (31.8%) vs. 20/118 (16.9%), p=0.009) and the proportion of moderate to severe AV (15/118 (13.6%) vs. 7/110 (5.9%), p=0.049) were significantly more frequent in the CIN group compared to healthy controls. We have found a significant association between aerobic vaginitis and cervical intraepithelial neoplasia. Further studies are needed to fully understand the relation between abnormal vaginal microbiota and the development of cervical cancer.