Clinical Observation Of High-grade Squamous Intraepithelial Lesions In Postmenopausal Women

Objective:1.To observe the clinical characteristics of postmenopausal patients with HSIL and improve the understanding of cervical lesions in postmenopausal women.2.To make statistics of the follow-up of postmenopausal patients with HSIL and clarify the necessity of health education and disease management.Methods:The clinical data of 286 postmenopausal patients with HSIL diagnosed were collected from January 2015 to December 2019 in the outpatient department of gynecology and obstetrics of Shanxi Bethune Hospital.The general data,clinical manifestations,screening results and follow-up of the patients were retrospectively analyzed.Results:1.The prevalence of post-menopausal women with HSIL is 51-60 years old,and the menopausal duration of the patients is mostly 1-10 years,accounting for 75.17% of the total number.2.Among 286 postmenopausal HSIL patients,177 patients had no clinical symptoms,accounting for 61.89% of the total number;109 patients had clinical symptoms,accounting for 38.11% of the total number,and 65 patients showed abnormal vaginal bleeding,accounting for 22.73% of the total number.3.The most common infection subtype in postmenopausal HSIL patients is HPV16,followed by HPV58,HPV52,HPV53,HPV33,HPV18 and so on.234 patients with HPV type detection as HR-HPV infection were counted,133 patients with single HR-HPV infection,accounting for 56.84%(133/234),101 patients with mixed HR-HPV infection,accounting for 43.16%(101/234).4.Telephone follow-up was conducted on 286 patients,193 patients had true information registration,accounting for 67.48%(193/286).There were 75 cases(26.22%)with false information registration.The authenticity of information registration was unknown in 18 cases,accounting for 6.30%(18/286).5.In the follow-up,163 patients received surgical treatment,accounting for 84.46%(163/193),22 patients treated with non-surgical treatment,accounting for 11.40%(22/193),8 patients gave up treatment for personal reasons,accounting for 4.14%(8/193).6.Among 163 postmenopausal HSIL patients who underwent surgical treatment,69 patients underwent cervical coning resection,accounting for 42.33%(69/163).Total hysterectomy was performed on 94 patients,accounting for 57.67%(94/163).Conclusion:1.The clinical characteristics of postmenopausal HSIL patients are as follows:(1)The high incidence age is 51 to 60 years old.(2)The menopausal duration of the patients is mostly 1-10 years.(3)Most patients have no obvious clinical symptoms,and abnormal vaginal bleeding is the most common clinical manifestation among symptomatic patients.(4)The common HPV infection subtype is HPV16,and the rest are HPV58,HPV52,HPV53,HPV33,HPV18 and so on.2.The authenticity of outpatient information registration of postmenopausal HSIL patients is low,and some patients did not received surgical treatment due to personal desire,so the health education and disease management should be strengthened to avoid delay of the condition.