A clinical study on screening and management of high-risk HPV infections and cervical lesions in postmenopausal women
HUANG Jun-ting
KONG Ling-hua
LOU Wei-zhen
SHI Xiao-hua
JIN Li
Abstract：Objective To explore the more effective screening methods and management strategies for high-risk human papilloma virus(HR-HPV)infections and cervical lesions in postmenopausal women.Methods A retrospective analysis was conducted on 289 postmenopausal patients who underwent colposcopic biopsy and surgical treatment at the Department of Gynecology,Peking Union Medical College Hospital,between January 2021 and September 2022,due to HR-HPV infection and/or abnormalities in ThinPrep cytologic test(TCT)results.The sensitivity of different screening methods was compared,and logistic regression analysis was used to identify risk factors for high-grade cervical lesions and for pathological upgrading after surgery.Results Health examinations,including HPV and TCT screenings,is the primary approach to identifying cervical lesions in postmenopausal women,accounting for 80.3％(232/289).HPV testing demonstrated significantly higher sensitivity than TCT(94.1％vs.76.0％)in detecting low-grade squamous intraepithelial lesions(LSIL)and above.HPV16,52,58,and 18 were the most prevalent HPV subtypes in postmenopausal women,with no significant difference in lesion grade across these types.Among patients with atypical squamous cells of undetermined significance(ASC-US)TCT results,95.45％(105/110)of colposcopic biopsies revealed low-grade squamous intraepithelial lesion(LSIL)or higher-grade lesion.Menopause duration was a risk factor for postoperative high-grade squamous intraepithelial lesions(HSIL)and above(OR=1.20,95％CI 1.02-1.42,P=0.028),but did not elevate the likelihood of pathological upgrading after surgery.Patients with first-time lesions persisting for≥1 year had a significantly increased risk of pathological escalation by colposcopic pathology compared to postoperative pathology(OR=2.385,95％CI 1.245-4.569,P=0.007).Conclusions Greater emphasis should be placed on HPV test outcomes in screening and managing cervical lesions in postmenopausal women,and the threshold for recommending colposcopy should be lowered accordingly.Diagnostic surgery is advised when necessary to clarify the nature and extent of cervical lesions.
Keywords：postmenopausal populationcervical lesionsHPV screeningTCT screeningcolposcopic evaluation
Publication Date：2025-05-02
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 548-552 )