Clinical Analysis Of High Risk HPV Typing In Cervical Lesions In Perimenopausal Women

Objective:To study the infection and distribution of high-risk HPV genotypes in different levels of cervical lesions in perimenopausal women,and to provide clinical basis for the prevention and treatment of cervical precancerous lesions in perimenopausal women.Method:To analyze the patients who visited the gynecological outpatient department of our hospital from January 2018 to January 2020,perimenopausal women aged 40-55 years old who met the indications of colposcopy were selected for colposcopy examination and tissue biopsy.Low grade squamous intraepithelial lesion(LSIL)was diagnosed on histomathology.There were 1366 perimenopausal women with High grade squamous intraepithelial disease(HSIL)and Cervical cancer(CC),who had undergone HPV classification in the gynecological outpatient department of our hospital before colposcopy.The HPV infection status and pathological examination results after colposcopy were collected.All the 1366 perimenopausal women had a life history before pathological biopsy,and had not received radiotherapy,chemotherapy,or estrogen therapy.The 1,366 perimenopausal women were divided into two groups:A and B.Group A was the pre-menopausal women in this age group,A total of 761 cases.Group B included 605 postmenopausal women in that age group.The characteristics of High risk Human papilloma virus(HR-HPV)type infection in different degrees of cervical lesions before and after menopause in this age group were analyzed statistically.Results:1.A total of 1366 perimenopausal women were enrolled in this study,and 1192 of them had HPV infection,all of which were high risk type HPV infection.There were 17 subtypes of high risk HPV detected,and the HPV infection rate was 87.26%(1192/1366).There were no significant differences in the age of first sexual intercourse,number of childbirth,number of abortions and number of sexual partners in the postmenopausal group(P>0.05).2.HPV infection was detected in 648 women in group A,with A positive rate of 85.15%(648/761).HPV infection was detected in 544 women in group B,with A positive rate of 89.92%(544/605).17 high-risk types were detected in both groups,and there was A statistical difference in the HPV detection rate between the two groups(P<0.05).Postmenopausal women are more likely to be infected with high-risk types of HPV than premenopausal women.3.According to the pathological results,the women in group A and B were divided into low-grade squamous intraepithelial lesion(LSIL),high-grade squamous intraepithelial lesion(HSIL),and cervical cancer(CC)group.The detection rate of high-risk HPV infection in the LSIL group in group A was 74.78%(252/337).The detection rate of high-risk HPV infection in the HSIL group was 93.04%(361/388).The detection rate of high-risk HPV infection in CC group was 97.22%(35/36).The detection rate of high-risk HPV subtypes in the three groups with different degrees of cervical lesions was different(χ~2=51.93,P<0.05),the difference was statistically significant.The detection rate of high-risk HPV infection in the LSIL group of group B was 82.11%(202/246).The detection rate of high-risk HPV infection in the HSIL group was 94.97%(302/318).The detection rate of high-risk HPV infection in the CC group was 97.56%(40/41).The detection rate of high-risk HPV subtypes in the three groups with different degree of cervical lesions was different(χ~2=28.55,P<0.05),the difference was statistically significant.4.In the groups of different degrees of cervical pathological changes before and after menopause,high-risk type HPV infection subtypes are difference With different degrees of cervical lesions in group A,group and HPV52 detection rates are highest in LSIL group’s top five HR-HPV infection don’t followed by HPV16,HPV52,HPV58,HPV18 and HPV33.HSIL group of the top five in HR-HPV infection don’t followed by HPV16,HPV52,HPV18,HPV58 and HPV33.HPV82 has not been checked out.The top 5 HR-HPV infection types in the CC group were HPV16,HPV52,HPV58,HPV18 and HPV31,among which HPV35,HPV39,HPV45,HPV56,HPV59,HPV66,HPV68,HPV73 and HPV82 were not detected.Among the different degrees of cervical lesions in the postmenopausal group,the infection types of high-risk HPV were also different,among which the detection rate of HPV16 was the highest in the HSIL group and the CC group.In the LSIL group,the detection rate of HPV58 was the highest,followed by the top 5 HR-HPV infection types in the HPV16 LSIL group were HPV58,HPV16,HPV18,HPV52,and the top 5 HR-HPV infection types in the HPV33 HSIL group were HPV16,HPV52,HPV18,HPV58,and HPV31,respectively.In the CC group,the top 5 HR-HPV infection types in the HPV73 and HPV82 were HPV16,HPV18,and HPV52,respectively HPV58and HPV31,in which HPV35,HPV39,HPV45,HPV53,HPV56,HPV-59,HPV66,HPV68,HPV73 and HPV82 were not detected.Conclusion:1.In the histopathologically confirmed perimenopausal cervical lesions,postmenopausal women have a higher infection rate of high-risk HPV than premenopausal women.Therefore,postmenopausal women are still at high risk of cervical lesions,and we should attach great importance to postmenopausal women who are positive for high-risk HPV infection.2.The occurrence of cervical lesions in perimenopausal women is closely related to the infection of high-risk HPV types.In this study,it was found that the high-risk HPV52,HPV58,HPV33 and HPV31 subtypes are closely related to the occurrence of cervical lesions in perimenopausal women except HPV16/18.For perimenopausal women infected with HPV16,HPV52,HPV58,HPV18,HPV33 and HPV31,great attention should be paid to them regardless of whether they are menopausal or not,and it is suggested that the infected women should be referred for colposcopy as soon as possible.