{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T15:36:46Z","timestamp":1775749006618,"version":"3.50.1"},"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015042","name":"R\u012bgas Stradi\u0146a Universit\u0101te","doi-asserted-by":"publisher","award":["RSU ZP 04 \/ 2013, kods 035"],"award-info":[{"award-number":["RSU ZP 04 \/ 2013, kods 035"]}],"id":[{"id":"10.13039\/501100015042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>High-risk human papillomavirus infection (HR-HPV) is necessary but not the only factor needed to develop cervical cancer. It is essential to estimate cervical cancer development risk in the population of high-risk HPV-positive women and to avoid unnecessary examinations and treatment in low-risk individuals. The study aimed to identify associations between different personal factors, vaginal microflora, sexually transmitted, high-risk HPV infection, and various degrees of cervical precancerous lesions. A study was performed in 2016\u20132020. The study group consisted of 112 patients with abnormal cervical cytology results referred for colposcopic examination. 120 women who came for a routine gynecological check-up were included in the control group. Material from the cervix and upper vaginal fornix was taken for pH measurement, wet mount microscopy, testing the six most common high-risk HPV DNA types (16\/18, 31, 33, 45, 58), HPV E6\/E7 mRNA, and 7 genital infections\u2013<jats:italic>C<\/jats:italic>. <jats:italic>trachomatis<\/jats:italic>, <jats:italic>N<\/jats:italic>. <jats:italic>gonorrhea<\/jats:italic>, <jats:italic>T<\/jats:italic>. <jats:italic>vaginalis<\/jats:italic>, <jats:italic>M<\/jats:italic>. <jats:italic>hominis<\/jats:italic>, <jats:italic>M<\/jats:italic>. <jats:italic>genitalium<\/jats:italic>, <jats:italic>U<\/jats:italic>. <jats:italic>urealyticum<\/jats:italic>, <jats:italic>U<\/jats:italic>. <jats:italic>parvum<\/jats:italic>. Results showed that women with all grades of cervical intraepithelial neoplasia (CIN) more often were smokers, had increased vaginal pH levels, and had positive HR-HPV DNA and HR HPV E6\/E7 mRNA expression. Abnormal vaginal microflora, especially types associated with aerobic vaginitis, and <jats:italic>M<\/jats:italic>. <jats:italic>hominis<\/jats:italic> were significantly more often found in women with CIN2+. The presence <jats:italic>of C<\/jats:italic>.<jats:italic>trachomatis<\/jats:italic>, <jats:italic>U<\/jats:italic>. <jats:italic>parvum<\/jats:italic>, <jats:italic>and U<\/jats:italic>.<jats:italic>urealyticum<\/jats:italic> did not differ between the groups. The most important factors independently associated with CIN2+ were positive high-risk HPV E6\/E7 mRNA expression (OR 59.4, 95% CI 14.84\u2013237.51), and positive high-risk HPV DNA (OR 3.9, 95% CI 1.16\u201313.23). Higher education level was associated with reduced risk of CIN2+ (OR 0.2, 95% CI 0.07\u20130.71). In conclusion, this study reports HR-HPV DNA of the most common six types and E6\/E7 mRNA positivity as the most significant factors associated with CIN2+ lesions and higher education related to lower risk of high-grade cervical lesions.<\/jats:p>","DOI":"10.1371\/journal.pone.0313004","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T18:33:48Z","timestamp":1731350028000},"page":"e0313004","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prediction of high-grade cervical precancerous abnormalities: The role of personal factors, vaginal microflora, sexually transmitted infections, and high-risk human papillomavirus"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-6180","authenticated-orcid":true,"given":"Olga","family":"Plisko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Zodzika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Jermakova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine","family":"Pcolkina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Prusakevica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inta","family":"Liepniece-Karele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Zarina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Storozenko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dace","family":"Rezeberga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"issue":"3","key":"pone.0313004.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"pone.0313004.ref002","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ygyno.2008.07.045","article-title":"Natural history and epidemiology of HPV infection and cervical cancer","volume":"110","author":"X. 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