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Cervical cancer and vaginal microbiota changes

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Microbial changes in vaginal ecosystem may accelerate the process of cervical carcinogenesis. The developed cervical cancer can lead to changes in the vaginal microbiota. The aim of our study is to determine the vaginal microbiota changes at women with FIGO I stage cervical cancer. We conducted an open, single-site survey in the Department of Gynecology of the Military Medical Academy in Sofia, Bulgaria, from 2014 to 2019 year. The study included a total of 32 women aged 38–55 years with clinical and pathology established cervical cancer (FIGO I stage). The underlying vaginal DNA microbiological test indicated presence or absence of bacterial vaginosis, other vaginal infections or normal vaginal microbiota. Of 32 (100%) women enrolled in our study, 19 (59.4%) was with FIGO IA stage cervical cancer and 13 (40.6%) with IB stage. Disturbances of vaginal microbiota in we found at 23 (71.9%) of women with cervical cancer included in our study. At the rest of 9 (28.1%) women we found out normal vaginal microbiota. Bacterial vaginosis was determined clinically and microbiologically in 15 (46.9%) women enrolled in the study. Aerobic vaginitis caused by Streptococcus species we establish at 4 (12.5%) of women. Trichomonas vaginalis infection have 1 (3.1%) women and Candida Albicans the last one 1 (3.1%) from this group with disturbed vaginal microbial balance. Bacterial dysbacteriosis, characterized by a predominance of Gardnerella vaginalis alone or in complex with other anaerobic bacteria, aerobic vaginitis and other sexually transmitted vaginal pathogens from one side and a concomitant paucity of vaginal Lactobacillus species may be an HPV-dependent cofactor for cervical neoplasia development. Only with this single observation it is difficult to confirm that vaginal microbiota dysbiosis contributes to HPV infection and carcinogenesis.

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  1. Audirac-Chalifour A, Torres-Poveda K, Bahena-Roman M, Tellez-Sosa J, Martinez-Barnetche J, Cortina-Ceballos B et al (2016) Cervical microbiome and cytokine profile at various stages of cervical cancer: a pilot study. PLoS ONE One 11:e0153274

  2. Biswal B, Singh K, Ismail M, Jalal M, Safruddin E (2014) Current concept of bacterial vaginosis in cervical cancer. J Clin Gynecol Obstet 3(1):1–7

  3. Brotman RM, Shardell MD, Gajer P et al (2014) Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection. J Infect Dis 210(11):1723–1733

  4. Chase D, Goulder A, Zenhausern F, Monk B, Herbst-Kralovetz M (2015) The vaginal and gastrointestinal microbiomes in gynecologic cancers: a review of applications in etiology, symptoms and treatment. Gynecol Oncol 138(1):190–200

  5. de Castro-Sobrinho JM, Rabelo-Santos SH, Fugueiredo-Alves RR, Derchain S, Sarian LO, Pitta DR, Campos EA, Zeferino LC (2016) Bacterial vaginosis and inflammatory response showed association with severity of cervical neoplasia in HPV-positive women. Diagn Cytopathol 44(2):80–86

  6. Engberts MK, Verbruggen BS, Boon ME, van Haaften M, Heintz AP (2007) Candida and dysbacteriosis: a cytologic, population-based study of 100,605 asymptomatic women concerning cervical carcinogenesis. Cancer 111:269–274

  7. Femoflor 16 REAL-TIME PCR Detection Kit. USER MANUAL. //www.dna-technology.ru//

  8. Lee JE, Lee S, Lee H, Song Y-M, Lee K, Han MJ et al (2013) Association of the vaginal microbiota with human papillomavirus infection in a Korean twin cohort. PLoS ONE One 8(5):e63514. https://doi.org/10.1371/journal.pone.0063514

  9. Mitra A, MacIntyre DA, Lee YS et al (2015a) The vaginal microbiome of women with cervical intraepithelial neoplasia. Microbiome 9(25):976–977

  10. Mitra A, MacIntyre DA, Lee YS et al (2015b) Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity. Sci Rep 5:16865

  11. Sierra LJ, Brown AG, Barilá GO et al (2018) Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice. PLoS ONE One 13(1):e0191524

  12. Sodhani P, Gupta S, Gupta R, Mehrotra R (2017) Bacterial vaginosis and cervical intraepithelial neoplasia: is there an association or is co-existence incidental? Asian Pac J Cancer Prev 18(5):1289–1292

  13. Verbruggen BS, Boon ME, Boon LM (2006) Dysbacteriosis and squamous (pre) neoplasia of immigrants and Dutch women as established in population-based cervical screening. Diagn Cytopathol 34(5):377–381

  14. Yang X, Da M, Zhang W, Qi Q, Zhang C, Han S (2018) Role of Lactobacillus in cervical cancer. Cancer Manag Res 10:1219–1229

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Correspondence to Stefan Miladinov Kovachev.

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Communicated by Erko Stackebrandt.

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Kovachev, S.M. Cervical cancer and vaginal microbiota changes. Arch Microbiol 202, 323–327 (2020). https://doi.org/10.1007/s00203-019-01747-4

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  • Cervical cancer
  • Vaginal microbiota
  • Changes
  • HPV
  • Dysbacteriosis