Objective To analyze the correlation of vaginal microecology, high-risk human papillomavirus (HR-HPV) infection, and cervical squamous intraepithelial lesions (SIL).

Methods A total of 83 women with SIL were collected and divided into high-grade SIL (HSIL) group (n=40) and low-grade SIL (LSIL) group (n=43) according to the pathological examination results, and 45 healthy women undergoing physical examinations during the same period were included as the control group. The HPV infection, vaginal discharge leukocyte esterase (LE), sialidase (SNA), N-acetyl-β-D-galactosaminidase (NAG), hydrogen peroxide (H₂O₂) positive rate, pH value, and cleanliness of subjects in the three groups were compared. The correlation between SIL and HR-HPV infection, vaginal microecology was analyzed.

Results The positive rates of SNA, LE, NAG, H₂O₂, and pH value in the LSIL group and HSIL group were higher than those in the control group (P < 0.05), and the infection rate of vaginal trichomonas and the positive rates of aerobic vaginitis (AV) and bacterial vaginosis (BV) were also higher than those in the control group (P < 0.05). The proportion of vaginal cleanliness grade Ⅰ°-Ⅱ° in the LSIL group and HSIL group was lower than that in the control group, while the proportion of vaginal cleanliness grade Ⅲ°-Ⅳ° was higher than that in the control group (P < 0.05). The HR-HPV infection rate and total incidence of HPV infection in the LSIL group and HSIL group were higher than those in the control group (P < 0.05). Spearman analysis showed that SIL was significantly positively correlated with vaginal pH value, HR-HPV infection, vaginal cleanliness, LE, NAG, SNA, H₂O₂ positive rate, trichomonas infection rate, AV, and BV (P < 0.01).

Conclusions SIL patients exhibit an imbalanced vaginal microecology. Cervical lesions are associated with HPV infection type, AV, BV, LE, NAG, SNA, H₂O₂ positive rates, pH value, and vaginal cleanliness.