GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum68785910.26442/20795696.2025.3.203393REVIEWОБЗОРResearch ArticleThe role of microbiota in the etiology of dysplastic and oncological diseases of the cervix, vagina, and vulva: A reviewРоль микробиоты в генезе диспластических и онкологических заболеваний шейки матки, влагалища и вульвыhttps://orcid.org/0000-0003-0574-1230MgeryanA. N.МгерянА. Н.
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, науч. сотр. научно-поликлинического отд-ния

docanna@mail.ruhttps://orcid.org/0000-0003-3993-7629PrilepskayaV. N.ПрилепскаяВ. Н.
Russian Federation

D. Sci. (Med.), Prof., Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

д-р мед. наук, проф., зав. научно-поликлиническим отд-нием ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова», засл. деят. науки РФ

docanna@mail.ruhttps://orcid.org/0000-0003-2835-6685DovletkhanovaE. R.ДовлетхановаЭ. Р.
Russian Federation

Cand. Sci. (Med.), Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

канд. мед. наук, ст. науч. сотр. научно-поликлинического отд-ния ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова»

docanna@mail.ruhttps://orcid.org/0000-0002-8243-5272AbakarovaP. R.АбакароваП. Р.
Russian Federation

Cand. Sci. (Med.), Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

канд. мед. наук, науч. сотр. научно-поликлинического отд-ния ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова»

docanna@mail.ruhttps://orcid.org/0000-0003-2977-9065MejevitinovaE. A.МежевитиноваЕ. А.
Russian Federation

D. Sci. (Med.), Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

д-р мед. наук, вед. науч. сотр. научно-поликлинического отд-ния ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова»

docanna@mail.ruKulakov National Medical Research Center for Obstetrics, Gynecology and PerinatologyФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России240920252731761821807202515092025Copyright ©; 2025, Consilium MedicumCopyright ©; 2025, ООО "Консилиум Медикум"2025Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/687859

The vaginal microbiota of a healthy woman is a unique microecosystem comprising more than 300 bacterial species. The main vaginal bacteria of a healthy woman are Lactobacillus spp. (90–95%), with the most common being L. crispatus, L. iners, L. jensenii, and L. gasseri. Based on the dominant Lactobacillus species, five types of communities are distinguished: CST I, II, III, IV, and V. Lactobacilli ensure a normal vaginal pH (3.8–4.4) and inhibit the growth of other microorganisms, particularly Escherichia coli, Trichomonas vaginalis, Gardnerella vaginalis, Prevotella bivia, etc. Different lactobacilli species produce different levels of reactive oxygen species. Many studies demonstrated a close relationship between vaginal microbiota disturbance and the development of malignancies, particularly cervical, vagina, and vulvar cancer. This review analyzes published studies, which showed a positive correlation between a low content of lactobacilli, an increase in the abundance of pathogenic bacteria, and cancer of the anogenital region; the association between some bacteria, the persistence of the human papillomavirus, and the development of dysplasia of the lower reproductive system was demonstrated. Timely diagnosis and treatment of vulvovaginal infections and vaginal dysbiosis would reduce the risk of human papillomavirus persistence and, consequently, the development of dysplasia and cancers of the lower genital tract.

Микробиота влагалища здоровой женщины представляет собой уникальную микроэкосистему, включающую более 300 видов бактерий. Основными бактериями влагалища здоровой женщины являются представители рода Lactobacillus − лактобактерии (90–95%), наиболее распространенные из которых L. crispatus, L. iners, L. jensenii и L. gasseri. В зависимости от доминирующего вида Lactobacillus выделяют пять типов сообществ − CST I, II, III, IV и V. Лактобактерии обеспечивают нормальный уровень рH влагалища (3,8–4,4), подавляют рост других микроорганизмов, в частности Escherichia coli, Trichomonas vaginalis, Gardnerella vaginalis, Prevotella bivia и др. Различные виды лактобактерий продуцируют разные уровни активных форм кислорода. Результаты многочисленных научных работ показали тесную взаимосвязь между нарушением микробиоты влагалища и развитием онкологических заболеваний, в частности шейки матки, влагалища и вульвы. В представленном обзоре проведен анализ научных исследований, в которых показана положительная корреляционная связь между низким содержанием лактобактерий, ростом представительства патогенных бактерий и раком аногенитальной области; демонстрируется взаимосвязь между некоторыми бактериями, персистенцией вируса папилломы человека и развитием диспластических процессов нижних отделов половой системы. Своевременная диагностика и лечение вульвовагинальных инфекций и дисбиоза влагалища позволят снизить риск персистенции вируса папилломы человека и, следовательно, развития диспластических процессов, а также рака нижних отделов половых путей.

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