Lei Shengyao, Wu Congquan, Zhong Siyi, Liu Yanmei, Peng Ke, Han Xiao, Chen Jialing, Li Chunlan, Gao Shujun
Department of Gynecology, Center of Diagnosis and Treatment for Cervical & Uterine Cavity Diseases, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Huangpu District, Shanghai 200011, China.
Shanghai Key Laboratory of Female Reproductive Endocrine-Related Disease, Fudan University, Shanghai 200011, China.
Open Life Sci. 2023 Aug 8;18(1):20220621. doi: 10.1515/biol-2022-0621. eCollection 2023.
This study aims to investigate the influence of topical estrogen management in postmenopausal patients who had undergone CO laser ablation for vaginal squamous intraepithelial lesions (SILs). The clinical data of 211 postmenopausal women with vaginal SILs were reviewed. Patients were divided into two groups by 2-month different management: Group 1 (intervention group): patients were treated with estrogen cream 0.5 g every other day and Group 2 (control group): no topical agent was used for the treatment of patients. In low-grade squamous intraepithelial lesions (LSILs), the response rates for patients in the intervention group and the control group were 49.1% (27/55) and 54.2% (16/48), respectively; human papillomavirus (HPV) status turned negative in 12 (12/38, 31.6%) patients of the intervention group and in 15 (15/35, 42.9%) patients of the control group. In high-grade squamous intraepithelial lesions (HSILs), the response rates for patients in the intervention group and the control group were 72.4% (42/58) and 78.0% (39/50), respectively, nearly 1.5 times higher than those of the LSIL patients; 22 (22/54, 40.7%) patients of the intervention groups and 12 (12/46, 26.1%) patients of the control group cleared the HPV infection. In postmenopausal patients, local use of estrogen cream improves the recognition of lesions and is conducive to precision medicine.
本研究旨在调查局部雌激素治疗对因阴道鳞状上皮内病变（SIL）接受CO2激光消融术的绝经后患者的影响。回顾了211例绝经后阴道SIL患者的临床资料。根据2个月的不同治疗方法将患者分为两组：第1组（干预组）：患者每隔一天使用0.5克雌激素乳膏；第2组（对照组）：患者不使用局部用药进行治疗。在低级别鳞状上皮内病变（LSIL）中，干预组和对照组患者的缓解率分别为49.1%（27/55）和54.2%（16/48）；干预组12例（12/38，31.6%）患者和对照组15例（15/35，42.9%）患者的人乳头瘤病毒（HPV）状态转为阴性。在高级别鳞状上皮内病变（HSIL）中，干预组和对照组患者的缓解率分别为72.4%（42/58）和78.0%（39/50），几乎是LSIL患者的1.5倍；干预组22例（22/54，40.7%）患者和对照组12例（12/46，26.1%）患者清除了HPV感染。在绝经后患者中，局部使用雌激素乳膏可提高病变的识别率，有利于精准医疗。
