Re-visiting the Association of Bacterial Vaginosis in Cervical Cancer: Findings of a Comparative Study with Other Gynae-Malignancies

Objective Association of bacterial vaginosis with cervical cancer is well established. However, there is scarcity of data on the frequency of vaginal microflora alteration in other gynaecological malignancies which does not have a infective etiology like cervical cancer (HPV association). Therefore, we have undertaken the study with the aim of studying the alteration of vaginal microbiota in patients attending our institute over a period of one year with the primary objective of estimating the prevalence of altered vaginal flora in cervical cancer patients and compare with patients suffering with other gynaecological malignancies. Methods After informed consent, smears were collected for vaginal pH and routine microscopy of vaginal smear. Wet mount of the vaginal smear was also examined. Gram staining of the smear was examined. The differences in selected variables between the BV-negative and BV-positive groups were evaluated. Results Among the consented patient, pH and clean smears were obtained in 191 patients with cervical cancer and 94 patients with non-cervical cancer. The mean vaginal pH of the cases was 6.66 (Range 3.00–9.00). The Gram stain smear of the cervical cases predominantly showed Gram negative bacilli, Gram variable curved rods suggestive of Gardenella & Mobiluncus species and few Gram-positive coccus in nonspecific arrangement. Intracellular Gram-negative intracellular diplococci suggestive of Gonococci was observed in two of the cases. The vaginal flora was unaltered in 11 (5.7%) cases. In the other group, the vaginal flora was unaltered in 49 (52.12%) women. The median pH of the control group was 4.96. The Gram stain smear of the predominantly shows Gram-positive bacilli, suggestive of lactobacillus species. Conclusion Findings of the study reveal that although the association of BV with cervical cancer is high, it is not unique for cervical cancer.