Association between Bacterial Vaginosis and Cervical Intraepithelial Neoplasia: Systematic Review and Meta-Analysis

作者：Gillet Evy; Meys Joris F A; Verstraelen Hans; Verhelst Rita; De Sutter Philippe; Temmerman Marleen; Vanden Broeck Davy^*

来源：PLos One, 2012, 7(10): e45201.

DOI：10.1371/journal.pone.0045201

Objective: Bacterial vaginosis (BV), the most common vaginal disorder among women of reproductive age, has been suggested as co-factor in the development of cervical cancer. Previous studies examining the relationship between BV and cervical intra-epithelial neoplasia (CIN) provided inconsistent and conflicting results. The aim of this study is to clarify the association between these two conditions. %26lt;br%26gt;Methods: A systematic review and meta-analysis were conducted to summarize published literature on the association between BV and cervical pre-cancerous lesions. An extensive search of electronic databases Medline (Pubmed) and Web of Science was performed. The key words %26apos;bacterial vaginosis%26apos; and %26apos;bacterial infections and vaginitis%26apos; were used in combination with %26apos;cervical intraepithelial neoplasia%26apos;, %26apos;squamous intraepithelial lesions%26apos;, %26apos;cervical lesions%26apos;, %26apos;cervical dysplasia%26apos;, and %26apos;cervical screening%26apos;. Eligible studies required a clear description of diagnostic methods used for detecting both BV and cervical precancerous lesions. Publications were included if they either reported odds ratios (OR) and corresponding 95% confidence intervals (CI) representing the magnitude of association between these two conditions, or presented data that allowed calculation of the OR. %26lt;br%26gt;Results: Out of 329 articles, 17 cross-sectional and 2 incidence studies were selected. In addition, two studies conducted in The Netherlands, using the national KOPAC system, were retained. After testing for heterogeneity and publication bias, meta-analysis and meta-regression were performed, using a random effects model. Although heterogeneity among studies was high (chi(2) = 164.7, p %26lt; 0.01, I-2 = 88.5), a positive association between BV and cervical pre-cancerous lesions was found, with an overall estimated odds ratio of 1.51 (95% CI, 1.24-1.83). Meta-regression analysis could not detect a significant difference between studies based on BV diagnosis, CIN diagnosis or study population. %26lt;br%26gt;Conclusions: Although most studies were cross-sectional and heterogeneity was high, this meta-analysis confirms a connection between BV and CIN.

• 出版日期2012-10-2