The relationship of vaginal microbiota with abnormal cervical cytology results (atypical squamous cells of undetermined significance) in patients with chronic endometritis
Dikke G.B., Sukhanov A.A., Kukarskaya I.I., Shilova N.V.
Objective: Assessment of the risk of abnormal cervical cytology results (atypical squamous cells of undetermined significance) depending on the composition of the vaginal microbiota in patients with chronic endometritis (CE).
Materials and methods: Design: analytical case-control study. Allocation into groups: Group I (n=496) – patients with CE and ASCUS; Group II (n=630) – patients with CE and no ASCUS. Examination methods – clinical and laboratory tests – determined the presence of opportunistic bacteria using real-time polymerase chain reaction (PCR) (qualitative and quantitative methods) and viruses (qualitative method), and an oncocytological examination was performed.
Results: In patients with CE, with a positive human papillomavirus (HPV) result, the risk of ASCUS was 15 times higher compared to patients with a negative HPV status (OR=15.44, 95% CI 4.86–49.02, p<0.001) in the absence of other indicators. Asymptomatic shedding of the herpes simplex virus (HSV) increased the risk of ASCUS by 6 times compared to its absence (OR=6.03, 95% CI 1.73–20.95), p<0.001). On the contrary, in this case, no vaginal dysbiosis was detected in patients, and the risk of ASCUS was the same as in patients with normocenosis (OR=0.94, 95% CI 0.82–1.80, p=0.41). However, one in three patients with CE and ASCUS were found to have co-infections, which increased the risk by 2-fold (OR=2.32, 95% CI 2.08–2.59, p<0.001) and by 1.5-fold (OR=1.44, 95% CI 1.12–1.85, p=0.03) for anaerobic dysbiosis. In the presence of vaginal dysbiosis, the risk of HPV infection was 1.5-fold higher, as was the risk of HSV infection.
Conclusion: In the overall cohort of patients with CE, vaginal dysbiosis, compared with normal vaginal dysbiosis, did not demonstrate an association with ASCUS, regardless of HPV status. The presence of a co-infection in the vagina increases the risk of ASCUS by 2-fold and anaerobic dysbiosis by 1.5-fold.
For citations: Dikke G.B., Sukhanov A.A., Kukarskaya I.I., Shilova N.V. The relationship of vaginal microbiota with abnormal cervical cytology results (atypical squamous cells of undetermined significance) in patients with chronic endometritis. Pharmateca. 2026;33(1):101-111. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.1.101-111
Authors’ contribution: Dikke G.B. – development of the concept, design and program of the study, analysis of the results of statistical processing of clinical material and their interpretation, search for literary sources, writing fragments of the article and editing it after review. Sukhanov A.A. – collection of clinical material, formation of an electronic database, writing fragments of the article. Kukarskaya I.I. – organization of the study at the clinical site, supervision during the study. Shilova N.V. – statistical analysis of the study results, writing fragments of the article.
Conflict of interest: The authors report no conflicts of interest and guarantee that the article is the original work of the authors.
Funding: The research was carried out at our own expense.
Ethical Approval: The study protocol was approved by the local Ethics Committee of the “Perinatal Center” (Tyumen, Russia) (final version of the protocol v3.0 dated July 20, 2019).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
Keywords
atypical squamous cells of undetermined significance
ASCUS
HPV infection
herpes simplex virus
vaginal dysbiosis
About the Authors
Galina B. Dikke, Dr. Sci. (Med.), Professor, Department of Obstetrics and Gynecology with a Course in Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; galadikke@yandex.ru, ORCID: https://orcid.org/0000-0001-9524-8962 (corresponding author)Anton A. Sukhanov, Dr. Sci. (Med.), Head of the Department of Family Planning and Reproduction, Perinatal Center; Associate Professor, Department of Obstetrics and Gynecology, Tyumen State Medical University, Tyumen, Russia; saa2505anton@yandex.ru, ORCID: https://orcid.org/0000-0001-9092-9136
Irina I. Kukarskaya, Dr. Sci. (Med.), Professor, Department of Obstetrics, Gynecology, and Resuscitation with the Course in Clinical Laboratory Diagnostics, Institute of Continuous Professional Development, Tyumen State Medical University; Chief Physician, Perinatal Center, Tyumen, Russia; Chief Specialist in Obstetrics and Gynecology, Department of Healthcare of the Tyumen Region, Tyumen, Russia; ORCID: https://orcid.org/0000-0002-8275-3553
Natalya V. Shilova, Cand. Sci. (Med.), Associate Professor, Department of Industrial Pharmacy, National Research Nuclear University MEPhI, Moscow, Russia; nvshilova@gmail.com, ORCID: https://orcid.org/0000-0001-6734-0147
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