Objective To explore the relationship between high-risk HPV infection and cervical HSIL in elderly women (≥ 65 years old),as well as the selection of surgical treatment methods. Method A retrospective analysis was conducted on 108 elderly female patients admitted to Beijing Obstetrics and Gynecology Hospital from January 1,2020 to December 31,2023,who were diagnosed with high-grade cervical intraepithelial lesions (including CINⅡ and CIN Ⅲ) based on pathological examination under vaginal endoscopy. Surgical treatment includes cervical conization and total hysterectomy. Result A total of 108 eligible cases were collected. Among them,there were 56 cases (51.85％) of combined HPV16/18 infections,and 47 cases (43.52％) of TCT indicating HSIL or above and ASC-H were consistent with postoperative pathology. ECC indicates 44 cases of HSIL. Nearly half of the patients chose total hysterectomy for treatment due to significant cervical atrophy. There was no statistically significant difference in HSIL levels between HPV16/18 infection and non HPV16/18 infection in vaginal biopsy (P=0.268). A study on the pathological conditions of cervical conization surgery showed that there was no statistically significant difference in the likelihood of positive margins between patients with HPV16/18 infection and high-risk HPV infections without HPV16/18 infection (P=0.341). Multivariate analysis showed that HPV16/18 infection was only associated with HSIL that indicated by ECC. Conclusions High risk HPV16/18 infection in postmenopausal elderly women remains one of the important factors causing cervical HSIL,and ECC plays a very important assisting role in the diagnosis of cervical HSIL in elderly people with cervical atrophy. For elderly women,it is still recommended to choose cervical conization as the preferred treatment for HSIL. Patients with significant cervical atrophy should be treated by experienced surgeons.
维普
万方数据