Association of Lactobacillus and Vaginal pH with Precancerous and Cancerous Lesions of the Cervix
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Abstract
Background: Cervical cancer is a significant global health issue, particularly in developing countries. Emerging evidence highlights the role of vaginal microbiota, especially Lactobacillus species and vaginal pH, in modulating susceptibility to human papillomavirus (HPV) infection and cervical carcinogenesis. This study aimed to investigate the association of Lactobacillus presence and vaginal pH with precancerous and cancerous cervical lesions.
Methods: A case-control study was conducted at the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, involving 120 women aged 20 to 85 years. Participants were categorized into three groups: Healthy (n=40), pre-cancerous (n=40), and Cancerous (n=40). Vaginal swabs were cultured to identify Lactobacillus, and vaginal pH was assessed using pH paper. Statistical analysis was performed using Chi-square and parametric tests.
Results: Lactobacillus was present in 93.1% of the Healthy group, 25.0% of the pre-cancerous group, and only 6.9% of the Cancerous group (p=0.001). Acidic vaginal pH was observed in 88.4% of Healthy women compared to 52.8% in the pre-cancerous and 11.6% in the Cancerous groups (p=0.001). A significant association was found between higher vaginal pH, reduced Lactobacillus, and presence of cervical lesions.
Conclusion: The findings demonstrate that diminished Lactobacillus presence and elevated vaginal pH are significantly associated with precancerous and cancerous cervical lesions. These biomarkers may serve as early indicators for cervical cancer risk, suggesting their potential inclusion in routine gynecological assessments.