Abstract: Objective: To investigate the clinical value of loop electrosurgical excision procedure (LEEP) in the diagnosis and treatment of high-grade cervical squamous intraepithelial lesions in postmenopausal women. Methods: 142 patients with high-grade squamous intraepithelial lesion (HSIL) who underwent LEEP in Department of Gynecology Minimal Invasive Center of Beijing Obstetrics and Gynecology Hospital from February 2017 to December 2018 were collected，including 40 patients in postmenopausal group, 102 patients in premenopausal group. All results of patients′ thinprep cytologic test (TCT), human papilloma virus (HPV) test, colposcopy and biopsy pathology, postoperative pathological examination and pathological examination of incision margin were collected. The data were compared between the two groups. Results: The difference of the cervical transformation zone type under colposcopy was significant between the two groups (χ2=28.658，P=0.000). The consistence rate of pathology between colposcopic biopsies and post-LEEP was 50.00% (20/40) in the group of postmenopausal women, and that in the group of premenopausal women was 51.96% (53/102). There was no statistical difference between the two groups ( χ2=0.044, P=0.854). In the group of postmenopausal women, 1 case of the pathological examination results after LEEP was escalated to cervical cancer. In the group of premenopausal women 1 case was escalated to cervical adenocarcinoma in situ. 8 cases′ surgical margins were positive in the group of postmenopausal women. The cases with positive surgical margins were 16 in the group of premenopausal women. The difference was not significant ( χ2=0.381, P=0.537). The difference of the results of TCT and HPV test after LEEP in the two groups was not significant (P＞0.05). Conclusions: LEEP is suitable for the diagnosis and treatment of HSIL in postmenopausal women without obvious cervical atrophy. It helps to avoid missed diagnosis and overtreatment.

Key words: Cervical intraepithelial neoplasia, Colposcopy, Menopause, Loop electrosurgical excision procedure