BMC infectious diseases · 2025
Cervical conization and high risk - HPV status changes in relation to menopause: a retrospective longitudinal study based on generalized additive mixed models.
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Zhou Jie, Su Lin Jie, Chen Juan, Hu Hong Bo
Аннотация
BACKGROUND: The relationship between high-risk human papillomavirus (HR-HPV) infection outcomes and cervical lesion recurrence after conization is well documented. However, the temporal dynamics of human papillomavirus (HPV) status post-conization, especially in postmenopausal women, remain unclear.
METHODS: This retrospective cohort study consecutively enrolled 598 patients who underwent conization, all of whom had baseline HR-HPV positivity and histologically confirmed cervical intraepithelial neoplasia (CIN) 2-3. All patients had at least one follow - up HPV test after surgery. Temporal changes in HPV status following conization and their association with menopause were analyzed using Generalized Additive Mixed Models (GAMM).
RESULTS: Among the 598 patients, GAMM analysis revealed a significant decrease in HPV positivity risk over time. Adjusting for confounders, the overall risk of HPV positivity decreased by 59% every 4 months within the first 24 months post-conization (OR: 0.41, 95% CI: 0.35-0.47). After 24 months, the risk continued to decline by 7% every 4 months (OR: 0.93, 95% CI: 0.81-1.06). Menopause status significantly influenced these temporal changes; postmenopausal patients had a 45% increased risk of HPV positivity every 4 months after conization compared to premenopausal patients (OR: 1.45, 95% CI: 1.13-1.85), particularly within the first 24 months (p = 0.0032).
CONCLUSIONS: In patients undergoing conization, longitudinal HPV infection status changes were independently associated with menopause. The risk of HPV positivity decreased significantly in the first 24 months post-surgery, with a more pronounced decline in premenopausal patients, informing HPV testing strategies post-conization.
METHODS: This retrospective cohort study consecutively enrolled 598 patients who underwent conization, all of whom had baseline HR-HPV positivity and histologically confirmed cervical intraepithelial neoplasia (CIN) 2-3. All patients had at least one follow - up HPV test after surgery. Temporal changes in HPV status following conization and their association with menopause were analyzed using Generalized Additive Mixed Models (GAMM).
RESULTS: Among the 598 patients, GAMM analysis revealed a significant decrease in HPV positivity risk over time. Adjusting for confounders, the overall risk of HPV positivity decreased by 59% every 4 months within the first 24 months post-conization (OR: 0.41, 95% CI: 0.35-0.47). After 24 months, the risk continued to decline by 7% every 4 months (OR: 0.93, 95% CI: 0.81-1.06). Menopause status significantly influenced these temporal changes; postmenopausal patients had a 45% increased risk of HPV positivity every 4 months after conization compared to premenopausal patients (OR: 1.45, 95% CI: 1.13-1.85), particularly within the first 24 months (p = 0.0032).
CONCLUSIONS: In patients undergoing conization, longitudinal HPV infection status changes were independently associated with menopause. The risk of HPV positivity decreased significantly in the first 24 months post-surgery, with a more pronounced decline in premenopausal patients, informing HPV testing strategies post-conization.