Abstract
There is an indirect link between multiple sexual partners (MSP) and cervical intraepithelial neoplasia (CIN) or even cervical cancer (CC). MSP may also lead to bacterial vaginosis (BV). The relationship among MSP, BV, human papillomavirus (HPV) infection and CIN/CC development in Chinese women remains unclear. The present study was designed to clarify their association. The study retrospectively analyzed 549 female patients who had visited a physical examination center. The MSP information was acquired, and vaginal microecology, HPV and cervical conization pathology (CCP) tests were performed when necessary. MSP status was distinct among patients with different levels of BV severity. In addition, as the severity of BV progressed, the HPV-positive ratio increased. Meanwhile, MSP was significantly associated with a positive HPV outcome, including HPV 16, HPV 18 and other high-risk HPV infections. The MSP group had a significantly higher percentage of positive CCP outcomes (particularly cases with CIN-II and CIN-III). Similarly, higher BV severity meant more severe CIN/CC progression. A logistic regression model based on age, MSP status and the Nugent score level was used in order to predict the CCP outcome. Furthermore, a receiver operating characteristic curve analysis resulted in an area under the curve of 0.834. In conclusion, the combination of MSP information and BV examination may provide a rapid, economic and accurate prediction of CIN/CC. Health education on sexual behavior and timely detection/treatment of BV should be conducted to reduce the risk of CC.