Clinical Analysis Of Low-grade Squamous Intraepithelial Lesions In Postmenopausal Women

Objective:To investigate the natural outcome of low-grade squamous intraepithelial lesions（LSIL）in postmenopausal women,and to explore the factors affecting the outcome of cervical intraepithelial disease,in order to provide a certain basis for screening,management and treatment of postmenopausal LSIL women.Methods:A retrospective analysis was performed on 532 postpostmenopausal patients diagnosed with LSIL in The Affiliated Hospital of Qingdao University from January 2018to December 2019.According to treatment methods,they were divided into expectation group,drug group,LEEP group,photodynamic group and laser group to evaluate their natural outcomes at 6,12 and 24 months.Statistical analysis was performed using SPSS26.0 software package,single factor analysis was performed on each factor,and then the factors with statistically significant differences were included in the Logistic regressionResults:1.24 months after the end of treatment,in the expectation group,four patients showed progression disease,with the progression rate of 6.2%;In the drug group,ten patients showed progression disease,with the progression rate of 8.7%.In LEEP group,fifteen showed progression disease,with the progression rate of 7.0%.In the ALA-PDT group,one patient showed progression disease,with the progression rate of 2.0%;In the CO₂ laser group,five patients showed progression diseases,with the progression rate of7.8%.There were no statistically significant differences in progression rates among groups.2.24 months after the end of treatment,the cure rate of cervical lesions in the ALA-PDT group was higher than that in the LEEP group and the laser group.And cure rate of cervical lesions that of above three groups were higher than the expectation and drug treatment group,the difference was statistically significant（P<0.05）.3.Six months after the end of treatment,the clearance rate of HR-HPV of PDT group and CO₂ laser group were higher than LEEP group,and they were both higher than expectation group and drug group,the difference was statistically significant（P<0.05）.4.12 or 24 months after the end of treatment,the clearance rate of HR-HPV of PDT group,CO2 laser group and LEEP group were higher than expectation group and drug group,the difference was statistically significant（P<0.05）.5.Postoperative LEEP pathological upgrading was associated with cytology suggesting ASC-H/HSIL and the involvement point number were greater than or equal to2.6.TCT results,HPV results were associated with predicting pathological upgrading in CINI patients（P<0.05）,multivariate logistic regression analysis of these factors revealed that persistent high risk HPV positivity was independent risk factor for predicting pathological upgrading in LSIL patients（P<0.05）Conclusions:1.The clearance rate of HPV in postpostmenopausal LSIL patients was increased over time within 24 months,and persistent high risk HPV positivity was independent risk factor for LSIL progression.2.The accuracy of cytological examination in postpostmenopausal women is low.The limited scope and depth of colposcopy biopsy,make long-term follow-up difficult,which make sense for active treatment.3.PDT and laser therapy are superior to LEEP in short-term clearance of HPV,and PDT therapy has better long-term efficacy than LEEP and laser therapy.