{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:46:50Z","timestamp":1782276410886,"version":"3.54.5"},"reference-count":62,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"NIH Center for Collaborative Research in Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54 MD007600"],"award-info":[{"award-number":["U54 MD007600"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"Puerto Rico Clinical and Translational Research Consortium","doi-asserted-by":"publisher","award":["U54MD007587"],"award-info":[{"award-number":["U54MD007587"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Puerto Rico IDeA Network Biomedical Research Excellence","award":["5P20GM103475-17"],"award-info":[{"award-number":["5P20GM103475-17"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Cervical cancer is primarily caused by the human papillomavirus (HPV), with persistent infections progressing to low- (LGSIL) and high-grade (HGSIL) lesions. Emerging evidence indicates that the cervicovaginal microbiota influences HPV persistence and disease progression, although the underlying metabolic mechanisms remain unclear. Therefore, we assessed the relationship between the cervicovaginal microbiota and the metabolic milieu in women with cervical dysplasia and HPV infections. Methods: We recruited 36 non-menopausal, non-pregnant women who were classified as negative, LGSIL, or HGSIL based on pathology and HPV results. Cervical swabs were collected for genomic DNA extraction to characterize bacterial communities using 16S rRNA sequencing and to perform HPV genotyping. Cervical lavages were collected for untargeted metabolomic profiling using Gas Chromatography-Mass Spectrometry. Integrative multiomic analysis was performed using the MIMOSA2 pipeline. Results: Although bacterial community structure was not different between groups, women with HGSIL had higher richness and exhibited a higher abundance of Prevotella bivia, Prevotella buccalis, and Lachnospiraceae G-9 oral taxon 924. Lesion-positive samples had shifts in tyramine and putrescine, biogenic amines linked to cancer development. Specifically, Pseudomonas was identified as a potential contributor to tyramine oxidation. Conclusions: Cervical lesions and HPV risk are associated with shifts in the cervicovaginal microbial metabolic milieu, highlighting the role of low-abundant anaerobic bacteria. Despite the small sample size, biogenic amines were associated with anaerobic taxa and microbial dysbiosis. These findings warrant further assessment of microbial-derived metabolites and their potential to promote tumor progression by driving a pro-inflammatory, metabolically altered microenvironment.<\/jats:p>","DOI":"10.3390\/cancers18121931","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:01:27Z","timestamp":1781492487000},"page":"1931","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervicovaginal Microbiota and Biogenic Amine Metabolic Shifts in HPV-Associated Cervical Disease"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-7557","authenticated-orcid":false,"given":"Natalie M.","family":"Mel\u00e9ndez-V\u00e1zquez","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-6802","authenticated-orcid":false,"given":"Nataliya","family":"Chorna","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1417-2383","authenticated-orcid":false,"given":"Cecilia","family":"Noecker","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Minnesota State University\u2014Mankato, Mankato, MN 56001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea P.","family":"Cortes-Nazario","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5403-9160","authenticated-orcid":false,"given":"Josefina","family":"Romaguera","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-0498","authenticated-orcid":false,"given":"Filipa","family":"Godoy-Vitorino","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"American Cancer Society (2024). Cancer Facts & Figures for Hispanic\/Latino People 2024\u20132026, American Cancer Society."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1001\/jamaoncol.2020.7488","article-title":"Incidence of Cervical Cancer in Puerto Rico, 2001\u20132017","volume":"7","author":"Ortiz","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"101236","DOI":"10.1016\/j.gore.2023.101236","article-title":"High Risk HPV Testing for Cervical Cancer Screening in a Puerto Rican Population","volume":"48","author":"Gustafson","year":"2023","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_5","first-page":"e00357-23","article-title":"The Cervical Microbiota of Hispanics Living in Puerto Rico Is Nonoptimal Regardless of HPV Status","volume":"8","author":"Romaguera","year":"2023","journal-title":"mSystems"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e00013-15","DOI":"10.1128\/mSystems.00013-15","article-title":"Metabolic Model-Based Integration of Microbiome Taxonomic and Metabolomic Profiles Elucidates Mechanistic Links between Ecological and Metabolic Variation","volume":"1","author":"Noecker","year":"2016","journal-title":"mSystems"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1080\/01443615.2019.1634030","article-title":"Human Papillomavirus and Cervical Cancer","volume":"40","author":"Okunade","year":"2019","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"28","DOI":"10.25259\/CMAS_03_07_2021","article-title":"The Bethesda System for Reporting Cervical Cytology","volume":"19","author":"Pangarkar","year":"2022","journal-title":"Cytojournal"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/LGT.0000000000000525","article-title":"2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors","volume":"24","author":"Perkins","year":"2020","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Zeber-Lubecka, N., Kulecka, M., Lindner, B., Krynicki, R., Paziewska, A., Nowakowski, A., Bidzinski, M., and Ostrowski, J. (2022). Increased Diversity of a Cervical Microbiome Associates with Cervical Cancer. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.1005537"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kang, G.U., Jung, D.R., Lee, Y.H., Jeon, S.Y., Han, H.S., Chong, G.O., and Shin, J.H. (2021). Potential Association between Vaginal Microbiota and Cervical Carcinogenesis in Korean Women: A Cohort Study. Microorganisms, 9.","DOI":"10.3390\/microorganisms9020294"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"So, K.A., Yang, E.J., Kim, N.R., Hong, S.R., Lee, J.H., Hwang, C.S., Shim, S.H., Lee, S.J., and Kim, T.J. (2020). Changes of Vaginal Microbiota during Cervical Carcinogenesis in Women with Human Papillomavirus Infection. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0238705"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1186\/s12967-025-06811-w","article-title":"Associations among HPV Persistence, the Vaginal Microbiome, and Cervical Cancer Recurrence","volume":"23","author":"Tsementzi","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Plesniarski, A., Siddik, A.B., and Su, R.C. (2021). The Microbiome as a Key Regulator of Female Genital Tract Barrier Function. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.790627"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal Microbiome of Reproductive-Age Women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Godoy-Vitorino, F., Romaguera, J., Zhao, C., Vargas-Robles, D., Ortiz-Morales, G., V\u00e1zquez-S\u00e1nchez, F., Sanchez-V\u00e1zquez, M., De La Garza-Casillas, M., Martinez-Ferrer, M., and White, J.R. (2018). Cervicovaginal Fungi and Bacteria Associated with Cervical Intraepithelial Neoplasia and High-Risk Human Papillomavirus Infections in a Hispanic Population. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.02533"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1158\/1940-6207.CAPR-24-0286","article-title":"Viewing Native American Cervical Cancer Disparities through the Lens of the Vaginal Microbiome: A Pilot Study","volume":"17","author":"Joe","year":"2024","journal-title":"Cancer Prev. Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Tosado-Rodr\u00edguez, E., Mendez, L.B., Espino, A.M., Dorta-Estremera, S., Aquino, E.E., Romaguera, J., and Godoy-Vitorino, F. (2023). Inflammatory Cytokines and a Diverse Cervicovaginal Microbiota Associate with Cervical Dysplasia in a Cohort of Hispanics Living in Puerto Rico. PLoS ONE, 18.","DOI":"10.1101\/2023.04.06.23288256"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Liu, J., Tian, R., Sun, C., Guo, Y., Dong, L., Li, Y., and Song, X. (2023). Microbial Metabolites Are Involved in Tumorigenesis and Development by Regulating Immune Responses. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1290414"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Nelson, T.M., Borgogna, J.L.C., Brotman, R.M., Ravel, J., Walk, S.T., and Yeoman, C.J. (2015). Vaginal Biogenic Amines: Biomarkers of Bacterial Vaginosis or Precursors to Vaginal Dysbiosis?. Front. Physiol., 6.","DOI":"10.3389\/fphys.2015.00253"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e03068-20","DOI":"10.1128\/AEM.03068-20","article-title":"Biogenic Amines Increase the Odds of Bacterial Vaginosis and Affect the Growth of and Lactic Acid Production by Vaginal Lactobacillus spp","volume":"87","author":"Borgogna","year":"2021","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/s41598-024-84796-0","article-title":"Metabolomic and Microbiota Profiles in Cervicovaginal Lavage Fluid of Women with High-Risk Human Papillomavirus Infection","volume":"15","author":"Shen","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/1471-0528.15981","article-title":"The Vaginal Metabolome and Microbiota of Cervical HPV-Positive and HPV-Negative Women: A Cross-Sectional Analysis","volume":"127","author":"Borgogna","year":"2019","journal-title":"BJOG"},{"key":"ref_24","unstructured":"McInnes, P., and Cutting, M. (2026, January 10). Manual of Procedures for Human Microbiome Project Core Microbiome Sampling Protocol A HMP Protocol # 07-001, Available online: https:\/\/www.ncbi.nlm.nih.gov\/projects\/gap\/cgi-bin\/document.cgi?study_id=phs000228.v3.p1&phd=3190."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1159\/000381842","article-title":"The Pap Test and Bethesda 2014: \u201cThe Reports of My Demise Have Been Greatly Exaggerated.\u201d (After a Quotation from Mark Twain)","volume":"59","author":"Nayar","year":"2015","journal-title":"Acta Cytol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s40168-020-00934-6","article-title":"VALENCIA: A Nearest Centroid Classification Method for Vaginal Microbial Communities Based on Composition","volume":"8","author":"France","year":"2020","journal-title":"Microbiome"},{"key":"ref_27","unstructured":"Signorell, A. (2025). DescTools: Tools for Descriptive Statistics. J. Data Anal. Inf. Process., 14."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/s41592-018-0141-9","article-title":"Qiita: Rapid, Web-Enabled Microbiome Meta-Analysis","volume":"15","author":"Gonzalez","year":"2018","journal-title":"Nat. Methods"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e00191-16","DOI":"10.1128\/mSystems.00191-16","article-title":"Deblur Rapidly Resolves Single-Nucleotide Community Sequence Patterns","volume":"2","author":"Amir","year":"2017","journal-title":"mSystems"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1038\/s41587-019-0209-9","article-title":"Reproducible, Interactive, Scalable and Extensible Microbiome Data Science Using QIIME 2","volume":"37","author":"Bolyen","year":"2019","journal-title":"Nat. Biotechnol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1038\/s41587-023-01845-1","article-title":"Greengenes2 Unifies Microbial Data in a Single Reference Tree","volume":"42","author":"McDonald","year":"2024","journal-title":"Nat. Biotechnol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"baq013","DOI":"10.1093\/database\/baq013","article-title":"The Human Oral Microbiome Database: A Web Accessible Resource for Investigating Oral Microbe Taxonomic and Genomic Information","volume":"2010","author":"Chen","year":"2010","journal-title":"Database"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1101\/gr.096651.109","article-title":"The NIH Human Microbiome Project","volume":"19","author":"Peterson","year":"2009","journal-title":"Genome Res."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"McMurdie, P.J., and Holmes, S. (2013). Phyloseq: An R Package for Reproducible Interactive Analysis and Graphics of Microbiome Census Data. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0061217"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wickham, H. (2009). Ggplot2: Elegant Graphics for Data Analysis, Springer. [2nd ed.].","DOI":"10.1007\/978-0-387-98141-3"},{"key":"ref_36","unstructured":"Oksanen, J., Guillaume Blanchet, F., Friendly, M., Kindt, R., Legendre, P., McGlinn, D., Minchin, P.R., O\u2019Hara, R.B., Simpson, G.L., and Solymos, P. (2026, January 10). Vegan: Community Ecology Package. Available online: https:\/\/vegandevs.github.io\/vegan\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"W180","DOI":"10.1093\/nar\/gkx295","article-title":"MicrobiomeAnalyst: A Web-Based Tool for Comprehensive Statistical, Visual and Meta-Analysis of Microbiome Data","volume":"45","author":"Dhariwal","year":"2017","journal-title":"Nucleic Acids Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Chorna, N., and Godoy-Vitorino, F. (2020). A Protocol for the Multi-Omic Integration of Cervical Microbiota and Urine Metabolomics to Understand Human Papillomavirus (HPV)-Driven Dysbiosis. Biomedicines, 8.","DOI":"10.3390\/biomedicines8040081"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Vazquez-Medina, A., Rodriguez-Trujillo, N., Ayuso-Rodriguez, K., Marini-Martinez, F., Angeli-Morales, R., Caussade-Silvestrini, G., Godoy-Vitorino, F., and Chorna, N. (2024). Exploring the Interplay between Running Exercises, Microbial Diversity, and Tryptophan Metabolism along the Microbiota-Gut-Brain Axis. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1326584"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"W398","DOI":"10.1093\/nar\/gkae253","article-title":"MetaboAnalyst 6.0: Towards a Unified Platform for Metabolomics Data Processing, Analysis and Interpretation","volume":"52","author":"Pang","year":"2024","journal-title":"Nucleic Acids Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1038\/s41587-020-0548-6","article-title":"PICRUSt2 for Prediction of Metagenome Functions","volume":"38","author":"Douglas","year":"2020","journal-title":"Nat. Biotechnol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1093\/bioinformatics\/btac003","article-title":"MIMOSA2: A Metabolic Network-Based Tool for Inferring Mechanism-Supported Relationships in Microbiome-Metabolome Data","volume":"38","author":"Noecker","year":"2022","journal-title":"Bioinformatics"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"D672","DOI":"10.1093\/nar\/gkae909","article-title":"KEGG: Biological Systems Database as a Model of the Real World","volume":"53","author":"Kanehisa","year":"2024","journal-title":"Nucleic Acids Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the Tidyverse","volume":"4","author":"Wickham","year":"2019","journal-title":"J. Open Source Softw."},{"key":"ref_45","unstructured":"Pederson, T.L. (2026, January 10). Patchwork: The Composer of Plots, R Package Version 1.3.1.9000. Available online: https:\/\/patchwork.data-imaginist.com\/."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.immuni.2016.12.013","article-title":"Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women","volume":"46","author":"Gosmann","year":"2017","journal-title":"Immunity"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1093\/infdis\/175.2.406","article-title":"Evidence for a Commensal, Symbiotic Relationship between Gardnerella Vaginalis and Prevotella Bivia Involving Ammonia: Potential Significance for Bacterial Vaginosis","volume":"175","author":"Pybus","year":"1997","journal-title":"J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Xie, Y., Feng, Y., Li, W., Zhan, F., Huang, G., Hu, H., Xiong, Y., Tan, B., and Chen, T. (2020). Revealing the Disturbed Vaginal Micobiota Caused by Cervical Cancer Using High-Throughput Sequencing Technology. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.538336"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"10200","DOI":"10.1038\/s41598-017-09842-6","article-title":"Characterization of Cervico-Vaginal Microbiota in Women Developing Persistent High-Risk Human Papillomavirus Infection","volume":"7","author":"Sani","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"16865","DOI":"10.1038\/srep16865","article-title":"Cervical Intraepithelial Neoplasia Disease Progression Is Associated with Increased Vaginal Microbiome Diversity","volume":"5","author":"Mitra","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Lee, J.E., Lee, S., Lee, H., Song, Y.M., Lee, K., Han, M.J., Sung, J., and Ko, G.P. (2013). Association of the Vaginal Microbiota with Human Papillomavirus Infection in a Korean Twin Cohort. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0063514"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Audirac-Chalifour, A., Torres-Poveda, K., Bahena-Rom\u00e1n, M., T\u00e9llez-Sosa, J., Mart\u00ednez-Barnetche, J., Cortina-Ceballos, B., L\u00f3pez-Estrada, G., Delgado-Romero, K., Burguete-Garc\u00eda, A.I., and Cant\u00fa, D. (2016). Cervical Microbiome and Cytokine Profile at Various Stages of Cervical Cancer: A Pilot Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0153274"},{"key":"ref_53","first-page":"23337","article-title":"Intratumoral Levels and Prognostic Significance of Fusobacterium Nucleatum in Cervical Carcinoma","volume":"12","author":"Huang","year":"2020","journal-title":"Aging"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2079814","DOI":"10.1080\/20002297.2022.2079814","article-title":"Prevotella Species as Oral Residents and Infectious Agents with Potential Impact on Systemic Conditions","volume":"14","author":"Fteita","year":"2022","journal-title":"J. Oral Microbiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/s10266-022-00763-z","article-title":"Streptococcus Anginosus: A Stealthy Villain in Deep Odontogenic Abscesses","volume":"111","author":"Furuholm","year":"2022","journal-title":"Odontology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"6457","DOI":"10.1128\/AEM.00895-08","article-title":"Isolation and Identification of Bifidobacteriaceae from Human Saliva","volume":"74","author":"Beighton","year":"2008","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Yeoman, C.J., Thomas, S.M., Miller, M.E.B., Ulanov, A.V., Torralba, M., Lucas, S., Gillis, M., Cregger, M., Gomez, A., and Ho, M. (2013). A Multi-Omic Systems-Based Approach Reveals Metabolic Markers of Bacterial Vaginosis and Insight into the Disease. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056111"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Li, T., Zhang, D., Zong, X., Bai, H., Bi, H., and Liu, Z. (2021). Distinction between Vaginal and Cervical Microbiota in High-Risk Human Papilloma Virus-Infected Women in China. BMC Microbiol., 21.","DOI":"10.1186\/s12866-021-02152-y"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Guo, Y., Xiao, Y., Zhang, C., Wang, Y., Cao, G., Tse, K.Y., Han, Z., Li, F., and Zhi, Y. (2025). The Intratumoral Microbiota Heterogenicity Is Related to the Prognosis and Tumorigenesis of Cervical Cancer. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1574511"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e00151-22","DOI":"10.1128\/spectrum.00151-22","article-title":"Association of Cervical Dysbacteriosis, HPV Oncogene Expression, and Cervical Lesion Progression","volume":"10","author":"Liu","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Lin, S., Zhang, B., Lin, Y., Lin, Y., and Zuo, X. (2022). Dysbiosis of Cervical and Vaginal Microbiota Associated with Cervical Intraepithelial Neoplasia. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.767693"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Liu, R., Bao, Z.X., Zhao, P.J., and Li, G.H. (2021). Advances in the Study of Metabolomics and Metabolites in Some Species Interactions. Molecules, 26.","DOI":"10.3390\/molecules26113311"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/12\/1931\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T03:51:38Z","timestamp":1782273098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/12\/1931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":62,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["cancers18121931"],"URL":"https:\/\/doi.org\/10.3390\/cancers18121931","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]}}}