Establishing a Predictive Model for Cervical Lesions/Cancer in Postmenopausal Women based on Changes in Vaginal Microenvironment

LIN Jun; JIN Qiong; SHEN Zhang; WU Sanshan

doi:10.3969/j.issn.1672-7185.2025.04.022

Abstract：Objective To explore the impact of changes in vaginal microenvironment on cervical lesions/cancer in postmenopausal women and establish a predictive model.Methods One hundred and twenty postmenopausal patients who visited the gynecology outpatient department of Fuzhou First Hospital affiliated with Fujian Medical University from September 2022 to September 2023 due to human papillomavirus(HPV)infection were selected.According to pathological results,they were divided into 20 cases of cervical cancer,50 cases of high-grade squamous intraepithelial lesion(HSIL)group,and 50 cases of low-grade squamous intraepithelial lesion(LSIL)group.One hundred postmenopausal women without cervical intraepithelial lesions were selected as the control group.The changes in vaginal microenvironment among different groups were compared.The multiple logistic regression analysis on the influencing factors of cervical lesions/cancer in postmenopausal women were conducted.And the predictive model for cervical lesions/cancer in postmenopausal women were established based on logistic regression analysis.Results The vaginal pH value,adnormal proportion of lactobacillus grading abnormal proportion of microbial community density and G-b(s)ratio showed that the cervical cancer group>HSIL group>LSIL group>control group(P<0.05).Logistic regression analysis indicated that pH value,abnormal Lactobacillus grading,flora density abnormalities,and dominant G-bacteria were independent risk factors for cervical lesions/cancer.The ROC curve area of the predictive model based on these factors was 0.811,with a sensitivity of 58.18%and a specificity of 96.19%.Conclusion Changes in the vaginal microenvironment are significant risk factors for cervical lesions/cancer in postmenopausal women.The predictive model based on these changes is valuable for the early detection and intervention of cervical lesions/cancer in postmenopausal women.