An Examination Of Cervical Squamous Intraepithelial Lesions In Postmenopausal Women With A High Risk Of HPV Infection

Objective: This study sought to explore the utility of cervical biopsy and cervical ring electroresection(LEEP)in the diagnosis of cervical squamous intraepithelial neoplasia in postmenopausal women,as well as to examine the elements associated with postoperative pathological intensification,and the essential part p16 and Ki67 play in the recognition and treatment of cervical lesions in menopausal women.Methods: A retrospective analysis was performed for the clinical data of 214 postmenopausal patients who underwent colposcopic cervical biopsy combined with cervical tube curettage(ECC)and hospitalized for cervical LEEP in Xinjiang Uygur Autonomous Region People’s Hospital(outpatient treatment room or hospitalization)from January 2018 to September2022,and divided into escalation group(50 cases)and non-escalation group(164 cases)according to whether the pathology after LEEP was upgraded,and the relationship between relevant factors and postoperative pathological escalation was compared..The comparison of p16 and Ki67 protein expression in various cervical lesions yielded a total agreement between the colposcopic cervical biopsy results and the pathological results after LEEP in 214 patients.Of these,51.40%(110/214)were in agreement,25.23%(54)were downgraded,23.37%(50)were upgraded,and 2.4%(5)were upgraded in the diagnosis of cervical cancer.An univariate analysis revealed a significant correlation between pathological progression after LEEP and the number of menopausal years,duration of HPV infection,HPV type,TCT type,lesion location in the cervical canal,colposcopic lesion involvement points,colposcopic biopsy highest diagnosis,and gland involvement(P<0.05).Binary logistic regression analysis,however,revealed a different result.HPV type,TCT type,colposcopic biopsy with the highest diagnosis,gland involvement,and cervical biopsy lesion involvement points were independent risk factors affecting the pathological progression after LEEP surgery(P<0.05).Conclusion: LEEP was comprehensively evaluated before surgery,including menopausal status,HPV type(16/18 positive),cervical cytology severity,number of lesion involvement points,menopausal age and lesion location.At the same time,other auxiliary diagnostic tools such as p16 immunostaining can be used,which is of great significance to the selection of treatment regimens.