Zeng Hongmin, Dai Qianling, Peng Jieru, Li Juan, Chen Jing, Lan Zhipeng, Wu Xia, Shu Ting, Yang Liu, Lin Wenyi, Li Mulan, Yang Xiao, Lin Yonghong
School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Qingyang District, Chengdu, 611731, Sichuan, People's Republic of China.
BMC Womens Health. 2025 Mar 27;25(1):143. doi: 10.1186/s12905-025-03675-6.
The incidence of cervical cancer is increasing in postmenopausal women globally, particularly in less-developed nations, including China. However, research on cervical cancer screening methods and related factors in China is limited. In the present study, we aimed to identify the independent risk factors associated with cervical lesions in postmenopausal women. Additionally, we compared the clinical characteristics and demographic information between women diagnosed with low-grade squamous intraepithelial lesions (LSIL) and those with high-grade squamous intraepithelial lesions+ (HSIL+).
We conducted a cross-sectional study using qualitative human papillomavirus (HPV) DNA testing for cervical cancer screening among postmenopausal women across 23 districts and counties in Chengdu, China. Multivariate logistic analysis was employed to analyze demographic information, clinical history, and auxiliary examinations to identify independent risk factors for cervical lesions in postmenopausal women.
A total of 917 patients participated in the study and were categorized as: 624 patients with LSIL (68.0%) and 293 patients with HSIL+ (32.0%). Multivariate analysis revealed that factors showing significant differences between two categories included co-infection with types 16 and 18 (adjusted odds ratio [aOR] = 0.348, 95% confidence interval [CI] = 0.138-0.881, p = 0.026), mixed infections involving other types, HPV 16/18 (aOR = 0.514, 95% CI = 0.336-0.785, p = 0.002), transformation zone (TZ) 3 (aOR = 1.604, 95% CI = 1.018-2.528, p = 0.041), and colposcopy impressions indicating high-grade features and worse (aOR = 11.846, 95% CI = 2.132-65.807, p = 0.005).
Co-infection with HPV types 16 and 18, as well as mixed infections involving HPV 16/18 and other types, TZ 3, and colposcopic features indicative of high-grade lesions and cancer, were identified as independent risk factors for HPV-related cervical lesions in postmenopausal women. Therefore, postmenopausal women with these high-risk factors need to undergo frequent cervical screening, and histopathological examination, if necessary.
全球范围内，绝经后女性宫颈癌的发病率呈上升趋势，尤其是在包括中国在内的欠发达国家。然而，中国关于宫颈癌筛查方法及相关因素的研究有限。在本研究中，我们旨在确定绝经后女性宫颈病变的独立危险因素。此外，我们比较了诊断为低度鳞状上皮内病变（LSIL）和高度鳞状上皮内病变+（HSIL+）的女性之间的临床特征和人口统计学信息。
我们在中国成都23个区县的绝经后女性中开展了一项横断面研究，采用定性人乳头瘤病毒（HPV）DNA检测进行宫颈癌筛查。采用多因素逻辑分析来分析人口统计学信息、临床病史和辅助检查结果，以确定绝经后女性宫颈病变的独立危险因素。
共有917名患者参与了本研究，并被分为：624例LSIL患者（68.0%）和293例HSIL+患者（32.0%）。多因素分析显示，两类之间存在显著差异的因素包括16型和18型共感染（调整优势比[aOR]=0.348，95%置信区间[CI]=0.138-0.881，p=0.026）、涉及其他类型的混合感染、HPV 16/18（aOR=0.514，95%CI=0.336-0.785，p=0.002）、转化区（TZ）3（aOR=1.604，95%CI=1.018-2.528，p=0.041）以及阴道镜检查印象提示高级别特征及更差情况（aOR=11.846，95%CI=2.132-65.807，p=0.005）。
HPV 16型和18型共感染、HPV 16/18与其他类型的混合感染、TZ 3以及提示高级别病变和癌症的阴道镜特征被确定为绝经后女性HPV相关宫颈病变的独立危险因素。因此，有这些高危因素的绝经后女性需要定期进行宫颈筛查，必要时进行组织病理学检查。
