生殖道微生物组在宫颈癌中的研究进展

doi:10.12280/gjfckx.20251276

摘要/Abstract

摘要：

高危型人乳头瘤病毒（human papilloma virus，HPV）持续感染是宫颈癌发生的关键基础，但多数感染可被宿主免疫清除，提示其致癌进程尚有其他因素协同驱动。生殖道微生物组主要栖息于阴道及宫颈黏膜，可经代谢产物与竞争排斥等机制维系微环境稳态并抵御病原体入侵。研究表明，伴随从单纯HPV感染、宫颈上皮内瘤变至宫颈浸润癌的病程演进，生殖道微生物组呈现以乳杆菌耗竭及厌氧菌多样性显著增加的动态重塑特征。这种微生态失衡不仅破坏宫颈-阴道黏膜屏障以协助HPV整合，还通过诱导持续慢性炎症、释放代谢产物等途径推动宫颈细胞恶性转化。因此，基于微生物组的干预策略在阻断HPV感染进程、辅助宫颈癌诊断及放化疗增效减毒等方面具备临床转化前景。

关键词: 宫颈肿瘤, 癌, 阴道, 子宫颈, 生殖道, 微生物群, 乳头状瘤病毒科

Abstract:

Persistent infection with high-risk human papilloma virus (HPV) is the key prerequisite for cervical carcinogenesis. However, most infections are cleared by the host immunity system, indicating that additional factors collaborate to drive the oncogenic process. The reproductive tract microbiome primarily inhabits the vaginal and cervical mucosa, where it maintains microenvironmental homeostasis and resists pathogen invasion through mechanisms such as metabolite production and competitive exclusion. Studies indicate that throughout the disease progression from simple HPV infection to cervical intraepithelial neoplasia (CIN) and ultimately to invasive cervical cancer, the reproductive tract microbiome undergoes dynamic remodeling, characterized by Lactobacillus depletion and a significant increase in anaerobic diversity. This dysbiosis not only disrupts the cervical-vaginal mucosal barrier to facilitate HPV integration, but also promotes malignant transformation by inducing persistent chronic inflammation and releasing specific metabolites. Therefore, microbiome-based intervention strategies hold translational promise for blocking HPV infection progression, aiding cervical cancer diagnosis, and enhancing the efficacy while reducing the toxicity of chemoradiotherapy.

Key words: Uterine cervical neoplasms, Carcinoma, Vagina, Cervix uteri, Reproductive tract, Microbiota, Papillomaviridae

王冰燕, 李凤虎. 生殖道微生物组在宫颈癌中的研究进展[J]. 国际妇产科学杂志, 2026, 53(2): 200-205.

WANG Bing-yan, LI Feng-hu. Research Progress on the Reproductive Tract Microbiome in Cervical Cancer[J]. Journal of International Obstetrics and Gynecology, 2026, 53(2): 200-205.

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