Meta-Analysis and Systematic Review of the Relationship between Cervical Lesions, HPV and Vaginal Community State Type

Background: Chronic HPV infection is a precursor of cervical cancer, which is largely caused by dysregulation of vaginal flora and other factors like abnormal H 2 O 2 , neuraminidase and insufficient vaginal hygiene. The relationship between HPV-induced cancer and vaginal microbiota is involved in the viral chronicity and also influences the disease prognosis. A meta-analysis system was used to evaluate the relationship between cervical lesions, HPV and vaginal microenvironment. Methods: PubMed, Web of Science, Cochrane and Embase databases were searched for relevant literature published from 2016 to December 2020. According to the inclusion and exclusion criteria, literature screening, data extraction and quality evaluation were carried out, and stata16 statistical software was used for Meta-analysis and systematic evaluation. Results: The overall relative risk of CST in 95% CI: 0.76-1.4, LSIL group compared with normal cytology group was 0.81. The overall relative risk of CST in the HSIL group and cervical cancer group was 0.77 and 1.26, respectively. It was found that there was publication bias in the HPV positive group (p-value of Begg and Egger were 0.067 and 0.247) and cervical cancer group (p-value of Begg and Egger were 0.677 and 0.457 respectively). There was a significant difference in CST III between HPV positive group and the LSIL group. Conclusion: Cervical lesions and HPV are related to the increase of vaginal microbial diversity, and HPV and LSIL groups are related to CST III, while HSIL and cervical cancer groups are related to CSTIV, which has a certain guiding significance for early clinical diagnosis, but further large-scale studies are needed to confirm our findings.