Microbiota vaginal y cáncer de cuello uterino.
Vaginal microbiome and cervical cancer.
Palabras clave:
microbioma, microbiota vaginal, Lactobacilos, disbiosis, cáncer del cuello uterino
Resumen
En esta revisión narrativa se analizó la interrelación entre el cáncer del cuello uterino y la microbiota vaginal. Se ha estimado que el 15% de todos los cánceres son producidos por virus y bacterias. El desarrollo de la biología molecular, la genética y la utilización de técnicas de secuenciación de alto rendimiento genómica o de secuenciación de colonias, ha permitido no solo conocer el componente fenotípico, sino también el componente genético de la microbiota vaginal y obtener un mejor conocimiento y entendimiento del comportamiento de la flora vaginal que, con anterioridad eran imposibles de determinar. Se ha establecido la relación de las alteraciones en la flora vaginal por hábitos de las mujeres, estado inmunológico y socioeconómico. La revisión de la literatura fue realizada electrónicamente en PubMed, Medline, ISI, DOAJ, Springer, Embase. Web of Knowledge, y Google Scholar para los artículos escritos en el idioma inglés. Los portales Scielo, Latindex, Imbiomed-L, Redalyc y Google Scholar fueron revisados en búsqueda de artículos escritos en el idioma español. El objetivo de esta revisión narrativa fue revisar la literatura y analizar las alteraciones de la microbiota vaginal, su efecto protector local y su papel en el desarrollo de cáncer cervical.
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Castanheira CP, Sallas ML, Almeida Lima R, Lorenzic NP, Terminib L. Microbiome and Cervical Cancer. Pathobiology 2021; 88:187–197. doi: 10.1159/000511477.
Urdaneta J, Nava ML, García J, Cepeda M, Baabel N, Salazar J, Contreras A, Mujica A. Conocimiento del cáncer de cuello uterino y hallazgos citológicos en mujeres de estratos socioeconómicos bajos. Rev Venez Oncol 2013;25(4):211-228.
Ortiz Serrano R, Uribe Pérez C, Díaz Martínez LA, Dangond Romero YR. Factores de riesgo para cáncer de cuello uterino. Rev Colomb Obstet Ginecol 2004;.55 (2) doi: https://doi.org/10.18597/rcog.602
Núñez JT, Delgado M, Girón H, Pino G. Prostitution and other cofactors in preinvasive and invasive lesions of the cervix. Aust N Z J Obstet Gynaecol 2004;44(3):239-43. doi: 10.1111/j.1479-828X.2004.00222.x..
Graham SV. The human papilloma virus replication cycle, and its links to cancer progression: a comprehensive review. Clin Sci (Lond) 2017;131(17):2201–21. doi: 10.1042/CS20160786
Castellsagué X. Natural history and epidemiology of HPV infection and cervical cancer. Gynecol Oncol 2008;110(3 Suppl 2): S4–7. PMID: 18760711 doi: 10.1016/j. ygyno.2008.07.045.
Rodríguez AC, Schiffman M, Herrero R, Wacholder S, Hildesheim A, Castle PE, Solomon D, Burk R. Proyecto Epidemiológico Guanacaste Group. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. J Natl Cancer Inst 2008;100(7):513-517. doi: 10.1093/jnci/djn044.
Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev 2003;16(1):1- 17. doi: 10.1128/CMR.16.1.1-17.2003.
Kyrgiou M, Mitra A, Moscicki AB. Does the vaginal microbiota play a role in the development of cervical cancer? Transl Res 2017;179:168-182. doi: 10.1016/j. trsl.2016.07.004. Epub 2016 Jul 15.
Chase D, Goulder A, Zenhausern F, Monk B, Herbst-Kralovetz M. The vaginal and gastro-intestinal microbiomes in gynecologic cancers: a review of applications in etiology, symptoms, and treatment. Gynecol Oncol 2015;138(1):190–200. doi: 10.1016/j.ygyno.2015.04.036. Epub 2015 May 5.
Champer M, Wong AM, Champer J, Brito IL, Messer PW, Hou JY, Wright JD. The role of the vaginal microbiome in gynaecological cancer. BJOG 2018;125(3):309- 315. doi: 10.1111/1471-0528.14631. Epub 2017 Apr 12.
Curty G, de Carvalho PS, Soares MA. The Role of the cervicovaginal microbiome on the genesis and as a biomarker of premalignant cervical intraepithelial neo-plasia and invasive cervical cancer. Int J Mol Sci. 2019;21(1):222. doi: 10.3390/ijms21010222.
Mitra A, MacIntyre DA, Lee YS, Smith A, Marchesi JR, Lehne B, Bhatia R, Lyons D, Paraskevaidis E, Li JV, Holmes E, Nicholson JK, Bennett PR, Kyrgiou M. Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity. Sci Rep 2015; 5:16865. doi: 10.1038/srep16865
Chen Z, Zhang Z, Zhang H, Xie B. Analysis of the oxidative stress status in nonspecific vaginitis and its role in vaginal epithelial cells apoptosis. Biomed Res Int 2015; 2015. https://doi.org/10.1155/2015/795656.
Piyathilake CJ, Ollberding NJ, Kumar R, Macaluso M, Alvarez RD, Morrow CD. Cervical microbiota associated with higher grade cervical intraepithelial neoplasia in women infected with high-risk human papillomaviruses. Cancer Prev Res (Phila) 2016;9(5):357-66. doi: 10.1158/1940-6207.CAPR-15-0350. Epub 2016 Mar 2.
Klebanoff SJ, Hillier SL, Eschenbach DA, Waltersdorph AM. Control of the microbial flora of the vagina by H O -generating lactobacilli. J Infect Dis 1991;164(1):94- 100.: 10.1093/infdis/164.1.94. doi: 10.1093/infdis/164.1.94
Matos A, Silva AP d, Medeiros R, Bicho MBM C. Microenvironment in Vagina as a Key-Player on Cervical Cancer: Interaction of Polymorphic Genetic Variants and Vaginal Microbiome as Co-Factors. In: Rajkumar, R., editor. Cervical Cancer Screening, Treatment and Prevention Universal Protocols for Ultimate Control [Internet]. London: Intech Open; 2018 [cited 2022 Mar 04]. Disponible en: https://www.intechopen.com/chapters/58696 doi: 10.5772/intechopen.73108.
Castelão C, da Silva AP, Matos A, Inácio Â, Bicho M, Medeiros R, Bicho MC. Association of myeloperoxidase polymorphism (G463A) with cervix cancer. Mol Cell Bio-chem. 2015;404(1-2):1-4. doi: 10.1007/s11010-015-2359-5. Epub 2015 Feb 21.
Garrett WS. Cancer and the microbiota. Science 2015;348(6230):80-6. doi: 10.1126/science.aaa4972.
Bhatt AP, Redinbo MR, Bultman SJ. The role of the microbiome in cancer development and therapy. CA Cancer J Clin 2017;67(4):326-344. doi: 10.3322/caac.21398. Epub 2017 May 8.
Rajagopala SV, Vashee S, Oldfield LM, Suzuki Y, Venter JC, Telenti A, Nelson KE. The human microbiome and cancer. Cancer Prev Res (Phila) 2017 ;10(4):226-234. doi: 10.1158/1940-6207.CAPR-16-0249. Epub 2017 Jan 17.
Núñez-Troconis J. Microbiota of vagina. Acta Sci Women Health 2022;4(1):42-52.
Núñez-Troconis J. Microbiota de la vagina. Rev Obstet Ginecol Venez 2022; 82 (1): 103-117. https://doi.org/10.51288/00820113.
Kalia N, Singh J, Kaur M. Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Ann Clin Microbiol Antimicrob [Internet] 2020 [consultado el 11 de marzo de 2023]; 19, 5 https://doi.org/10.1186/s12941-020-0347-4.
Martin DH. The microbiota of the vagina and its influence on women’s health and disease. Am J Med Sci. 2012;343(1):2-9. doi: 10.1097/MAJ.0b013e31823ea228.
Walther-António MR, Chen J, Multinu F, Hokenstad A, Distad TJ, Cheek EH, Keeney GL, Creedon DJ, Nelson H, Mariani A, Chia N. Potential contribution of the uterine microbiome in the development of endometrial cancer. Genome Med 2016;8(1):122. doi: 10.1186/s13073-016-0368-y.
Banerjee S, Tian T, Wei Z, Shih N, Feldman MD, Alwine JC, Coukos G, Robertson ES. The ovarian cancer oncobiome. Oncotarget 2017;8(22):36225-36245. doi: 10.18632/oncotarget.16717.
Mitra A, MacIntyre DA, Marchesi JR, Lee YS, Bennett PR, Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neo-plasia: what do we know and where are we going next? Microbiome 2016;4(1):58 doi:10.1186/s40168-016-0203-0.
Vyshenska D, Lam KC, Shulzhenko N, Morgun A. Interplay between viruses and bacterial microbiota in cancer development. Semin Immunol 2017;32:14-24. doi: 10.1016/j. smim.2017.05.003. Epub 2017 Jun 9.
Brotman RM, Shardell MD, Gajer P, Tracy JK, Zenilman JM, Ravel J, Gravitt PE. Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection. J Infect Dis 2014;210(11):1723-33. doi: 10.1093/inf-dis/jiu330. Epub 2014 Jun 18.
Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health 2016;4(9):e609-16. doi: 10.1016/S2214-109X(16)30143-7. Epub 2016 Jul 25.
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999;189(1):12-9. doi: 10.1002/ (SICI)1096-9896(199909)189:1<12::AID- PATH431>3.0.CO;2-F.
Shulzhenko N, Lyng H, Sanson GF, Morgun A. Ménage à trois: an evolutionary interplay between human papillomavirus, a tumor, and a woman. Trends Microbiol 2014;22(6):345-53. doi: 10.1016/j. tim.2014.02.009. Epub 2014 Mar 24.
Amabebe E, Anumba DOC. The vaginal microenvironment: The physiologic role of Lactobacilli. Front Med (Lausanne) 2018; 5:181. doi: 10.3389/fmed.2018.00181.
Ventolini G, Vieira-Baptista P, De Seta F, Verstraelen H, Lonnee-Hoffmann R, Lev-Sagie A. The Vaginal Microbiome: IV. The role of vaginal microbiome in reproduction and in gynecologic cancers. J Low Genit Tract Dis 2022;26(1):93-98. doi: 10.1097/LGT.0000000000000646.
Łaniewski P, Ilhan ZE, Herbst-Kralovetz MM. The microbiome and gynaecological cancer development, prevention and therapy. Nat Rev Urol 2020;17(4):232-250. doi: 10.1038/s41585-020-0286-z. Epub 2020 Feb 18.
Norenhag J, Du J, Olovsson M, Verstraelen H, Engstrand L, Brusselaers N. The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis. BJOG 2020;127(2):171-180. doi: 10.1111/1471-0528.15854. Epub 2019 Jul 17.
Brusselaers N, Shrestha S, van de Wijgert J, Verstraelen H. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis. Am J Obstet Gynecol 2019;221(1):9- 18.e8. doi: 10.1016/j.ajog.2018.12.011. Epub 2018 Dec 12. Wang H, Ma Y, Li R, Chen X, Wan L, Zhao
W. Associations of cervicovaginal lactobacilli with high-risk Human Papillomavirus infection, cervical intraepithelial neoplasia, and cancer: A systematic review and meta-analysis. J Infect Dis 2019;220(8):1243- 1254. doi: 10.1093/infdis/jiz325.
Laniewski P, Barnes D, Goulder A, Cui H, Roe DJ, Chase DM, H, Herbst-Kralovetz MM. Linking cervicovaginal immune signatures, HPV and microbiota composition in cervical carcinogenesis in non-Hispanic and Hispanic women. Sci Rep 2018; 8: 7593 https://doi.org/10.1038/s41598-018-25879-7.
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Brotman RM, Shardell MD, Gajer P, Tracy JK, Zenilman JM, Ravel J, Gravitt PE. Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection. J Infect Dis 2014 ;210(11):1723-33. doi: 10.1093/infdis/jiu330. Epub 2014 Jun 18.
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Piyathilake CJ, Ollberding NJ, Kumar R, Macaluso M, Alvarez RD, Morrow CD. Cervical microbiota associated with higher grade cervical intraepithelial neoplasia in women infected with high-risk human papillomaviruses. Cancer Prev Res (Phila) 2016;9(5):357-66. doi: 10.1158/1940-6207.CAPR-15-0350. Epub 2016 Mar 2.
Shannon B, Yi TJ, Perusini S, Gajer P, Ma B, Humphrys MS, Thomas-Pavanel J, Chieza L, Janakiram P, Saunders M, Tharao W, Huibner S, Shahabi K, Ravel J, Rebbapragada A, Kaul R. Association of HPV infection and clearance with cervico- vaginal immunology and the vaginal micro-biota. Mucosal Immunol 2017;10(5):1310- 1319. doi: 10.1038/mi.2016.129. Epub 2017 Jan 25.
Łaniewski P4, Cui H, Roe DJ, Barnes D, Goulder A, Monk BJ, Greenspan DL, Chase DM, Herbst-Kralovetz MM. Features of the cervicovaginal microenvironment drive cancer biomarker signatures in patients across cervical carcinogenesis. Sci Rep 2019;9(1):7333. doi: 10.1038/ s41598-019-43849-5.
Urdaneta J, Nava ML, García J, Cepeda M, Baabel N, Salazar J, Contreras A, Mujica A. Conocimiento del cáncer de cuello uterino y hallazgos citológicos en mujeres de estratos socioeconómicos bajos. Rev Venez Oncol 2013;25(4):211-228.
Ortiz Serrano R, Uribe Pérez C, Díaz Martínez LA, Dangond Romero YR. Factores de riesgo para cáncer de cuello uterino. Rev Colomb Obstet Ginecol 2004;.55 (2) doi: https://doi.org/10.18597/rcog.602
Núñez JT, Delgado M, Girón H, Pino G. Prostitution and other cofactors in preinvasive and invasive lesions of the cervix. Aust N Z J Obstet Gynaecol 2004;44(3):239-43. doi: 10.1111/j.1479-828X.2004.00222.x..
Graham SV. The human papilloma virus replication cycle, and its links to cancer progression: a comprehensive review. Clin Sci (Lond) 2017;131(17):2201–21. doi: 10.1042/CS20160786
Castellsagué X. Natural history and epidemiology of HPV infection and cervical cancer. Gynecol Oncol 2008;110(3 Suppl 2): S4–7. PMID: 18760711 doi: 10.1016/j. ygyno.2008.07.045.
Rodríguez AC, Schiffman M, Herrero R, Wacholder S, Hildesheim A, Castle PE, Solomon D, Burk R. Proyecto Epidemiológico Guanacaste Group. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. J Natl Cancer Inst 2008;100(7):513-517. doi: 10.1093/jnci/djn044.
Burd EM. Human papillomavirus and cervical cancer. Clin Microbiol Rev 2003;16(1):1- 17. doi: 10.1128/CMR.16.1.1-17.2003.
Kyrgiou M, Mitra A, Moscicki AB. Does the vaginal microbiota play a role in the development of cervical cancer? Transl Res 2017;179:168-182. doi: 10.1016/j. trsl.2016.07.004. Epub 2016 Jul 15.
Chase D, Goulder A, Zenhausern F, Monk B, Herbst-Kralovetz M. The vaginal and gastro-intestinal microbiomes in gynecologic cancers: a review of applications in etiology, symptoms, and treatment. Gynecol Oncol 2015;138(1):190–200. doi: 10.1016/j.ygyno.2015.04.036. Epub 2015 May 5.
Champer M, Wong AM, Champer J, Brito IL, Messer PW, Hou JY, Wright JD. The role of the vaginal microbiome in gynaecological cancer. BJOG 2018;125(3):309- 315. doi: 10.1111/1471-0528.14631. Epub 2017 Apr 12.
Curty G, de Carvalho PS, Soares MA. The Role of the cervicovaginal microbiome on the genesis and as a biomarker of premalignant cervical intraepithelial neo-plasia and invasive cervical cancer. Int J Mol Sci. 2019;21(1):222. doi: 10.3390/ijms21010222.
Mitra A, MacIntyre DA, Lee YS, Smith A, Marchesi JR, Lehne B, Bhatia R, Lyons D, Paraskevaidis E, Li JV, Holmes E, Nicholson JK, Bennett PR, Kyrgiou M. Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity. Sci Rep 2015; 5:16865. doi: 10.1038/srep16865
Chen Z, Zhang Z, Zhang H, Xie B. Analysis of the oxidative stress status in nonspecific vaginitis and its role in vaginal epithelial cells apoptosis. Biomed Res Int 2015; 2015. https://doi.org/10.1155/2015/795656.
Piyathilake CJ, Ollberding NJ, Kumar R, Macaluso M, Alvarez RD, Morrow CD. Cervical microbiota associated with higher grade cervical intraepithelial neoplasia in women infected with high-risk human papillomaviruses. Cancer Prev Res (Phila) 2016;9(5):357-66. doi: 10.1158/1940-6207.CAPR-15-0350. Epub 2016 Mar 2.
Klebanoff SJ, Hillier SL, Eschenbach DA, Waltersdorph AM. Control of the microbial flora of the vagina by H O -generating lactobacilli. J Infect Dis 1991;164(1):94- 100.: 10.1093/infdis/164.1.94. doi: 10.1093/infdis/164.1.94
Matos A, Silva AP d, Medeiros R, Bicho MBM C. Microenvironment in Vagina as a Key-Player on Cervical Cancer: Interaction of Polymorphic Genetic Variants and Vaginal Microbiome as Co-Factors. In: Rajkumar, R., editor. Cervical Cancer Screening, Treatment and Prevention Universal Protocols for Ultimate Control [Internet]. London: Intech Open; 2018 [cited 2022 Mar 04]. Disponible en: https://www.intechopen.com/chapters/58696 doi: 10.5772/intechopen.73108.
Castelão C, da Silva AP, Matos A, Inácio Â, Bicho M, Medeiros R, Bicho MC. Association of myeloperoxidase polymorphism (G463A) with cervix cancer. Mol Cell Bio-chem. 2015;404(1-2):1-4. doi: 10.1007/s11010-015-2359-5. Epub 2015 Feb 21.
Garrett WS. Cancer and the microbiota. Science 2015;348(6230):80-6. doi: 10.1126/science.aaa4972.
Bhatt AP, Redinbo MR, Bultman SJ. The role of the microbiome in cancer development and therapy. CA Cancer J Clin 2017;67(4):326-344. doi: 10.3322/caac.21398. Epub 2017 May 8.
Rajagopala SV, Vashee S, Oldfield LM, Suzuki Y, Venter JC, Telenti A, Nelson KE. The human microbiome and cancer. Cancer Prev Res (Phila) 2017 ;10(4):226-234. doi: 10.1158/1940-6207.CAPR-16-0249. Epub 2017 Jan 17.
Núñez-Troconis J. Microbiota of vagina. Acta Sci Women Health 2022;4(1):42-52.
Núñez-Troconis J. Microbiota de la vagina. Rev Obstet Ginecol Venez 2022; 82 (1): 103-117. https://doi.org/10.51288/00820113.
Kalia N, Singh J, Kaur M. Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Ann Clin Microbiol Antimicrob [Internet] 2020 [consultado el 11 de marzo de 2023]; 19, 5 https://doi.org/10.1186/s12941-020-0347-4.
Martin DH. The microbiota of the vagina and its influence on women’s health and disease. Am J Med Sci. 2012;343(1):2-9. doi: 10.1097/MAJ.0b013e31823ea228.
Walther-António MR, Chen J, Multinu F, Hokenstad A, Distad TJ, Cheek EH, Keeney GL, Creedon DJ, Nelson H, Mariani A, Chia N. Potential contribution of the uterine microbiome in the development of endometrial cancer. Genome Med 2016;8(1):122. doi: 10.1186/s13073-016-0368-y.
Banerjee S, Tian T, Wei Z, Shih N, Feldman MD, Alwine JC, Coukos G, Robertson ES. The ovarian cancer oncobiome. Oncotarget 2017;8(22):36225-36245. doi: 10.18632/oncotarget.16717.
Mitra A, MacIntyre DA, Marchesi JR, Lee YS, Bennett PR, Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neo-plasia: what do we know and where are we going next? Microbiome 2016;4(1):58 doi:10.1186/s40168-016-0203-0.
Vyshenska D, Lam KC, Shulzhenko N, Morgun A. Interplay between viruses and bacterial microbiota in cancer development. Semin Immunol 2017;32:14-24. doi: 10.1016/j. smim.2017.05.003. Epub 2017 Jun 9.
Brotman RM, Shardell MD, Gajer P, Tracy JK, Zenilman JM, Ravel J, Gravitt PE. Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection. J Infect Dis 2014;210(11):1723-33. doi: 10.1093/inf-dis/jiu330. Epub 2014 Jun 18.
Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health 2016;4(9):e609-16. doi: 10.1016/S2214-109X(16)30143-7. Epub 2016 Jul 25.
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999;189(1):12-9. doi: 10.1002/ (SICI)1096-9896(199909)189:1<12::AID- PATH431>3.0.CO;2-F.
Shulzhenko N, Lyng H, Sanson GF, Morgun A. Ménage à trois: an evolutionary interplay between human papillomavirus, a tumor, and a woman. Trends Microbiol 2014;22(6):345-53. doi: 10.1016/j. tim.2014.02.009. Epub 2014 Mar 24.
Amabebe E, Anumba DOC. The vaginal microenvironment: The physiologic role of Lactobacilli. Front Med (Lausanne) 2018; 5:181. doi: 10.3389/fmed.2018.00181.
Ventolini G, Vieira-Baptista P, De Seta F, Verstraelen H, Lonnee-Hoffmann R, Lev-Sagie A. The Vaginal Microbiome: IV. The role of vaginal microbiome in reproduction and in gynecologic cancers. J Low Genit Tract Dis 2022;26(1):93-98. doi: 10.1097/LGT.0000000000000646.
Łaniewski P, Ilhan ZE, Herbst-Kralovetz MM. The microbiome and gynaecological cancer development, prevention and therapy. Nat Rev Urol 2020;17(4):232-250. doi: 10.1038/s41585-020-0286-z. Epub 2020 Feb 18.
Norenhag J, Du J, Olovsson M, Verstraelen H, Engstrand L, Brusselaers N. The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis. BJOG 2020;127(2):171-180. doi: 10.1111/1471-0528.15854. Epub 2019 Jul 17.
Brusselaers N, Shrestha S, van de Wijgert J, Verstraelen H. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis. Am J Obstet Gynecol 2019;221(1):9- 18.e8. doi: 10.1016/j.ajog.2018.12.011. Epub 2018 Dec 12. Wang H, Ma Y, Li R, Chen X, Wan L, Zhao
W. Associations of cervicovaginal lactobacilli with high-risk Human Papillomavirus infection, cervical intraepithelial neoplasia, and cancer: A systematic review and meta-analysis. J Infect Dis 2019;220(8):1243- 1254. doi: 10.1093/infdis/jiz325.
Laniewski P, Barnes D, Goulder A, Cui H, Roe DJ, Chase DM, H, Herbst-Kralovetz MM. Linking cervicovaginal immune signatures, HPV and microbiota composition in cervical carcinogenesis in non-Hispanic and Hispanic women. Sci Rep 2018; 8: 7593 https://doi.org/10.1038/s41598-018-25879-7.
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Publicado
2024-02-15
Cómo citar
Núñez-Troconis, J., & Molero, A. (2024). Microbiota vaginal y cáncer de cuello uterino.: Vaginal microbiome and cervical cancer. Investigación Clínica, 65(1), 109-119. https://doi.org/10.54817/IC.v65n1a10
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