Association of Vaginal Lactobacillus Status with Cervical Intraepithelial Neoplasia

Author(s): Nahida Yeasmin, Jannatul Ferdous, Fawzia Hossain, Md. Abdullah Yusuf, Sabiha Yeasmin, Tanzina Iveen Chowdhury, Marzina Faruq, Sharmin Akter, A. K. M Shahidur Rahman

Background: Female cervix and vagina maintain a microecology, that have a symbiotic relationship with the host and serve a crucial role in cervico-vaginal health. The cervical microbial flora has a prevalence of Lactobacillus species, which produce lactic acids that maintain an acidic environment and may inhibit pathogenic growth. Objective: To assess the association between vaginal Lactobacillus status with cervical intraepithelial neoplasia (CIN). Methodology: This cross-sectional analytical study was carried out at the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Study population comprised of 66 women, of them 33 had cervical intraepithelial neoplasia (CIN) and 33 were women with healthy cervix. Women with healthy cervix and women with CIN were confirmed by colposcopy and histopathology. Cervico-vaginal Lactobacillus was analyzed by culture in De Man Rogosa Sharpe (MRS) agar media and conventional polymerase chain reaction (PCR). Data were analyzed and compared by statistical tests. Results: The mean age of the women with CIN was 37.56±10.59 years and most of them (72.7%) were belonged to the age of >35 years. Regarding Lactobacillus status among the groups showed that, low level of Lactobacillus (0-1000 copy/cmm) was in 90.9% of women with CIN and 6.1% in women with healthy cervix group. A significant decrease of Lactobacillus was found in women with CIN compared to women with healthy cervix group (p<0.05). It was observed that, a low Lactobacillus status has 4.034 times increased risk of developing CIN (95% CI=0.047-36.199, p<0.05). Conclusion: It could be assumed that vaginal low Lactobacillus status is associated with cervical intraepithelial neoplasia (CIN).