Vaginal microbiota and functional prediction along the progression of cervical lesions in postmenopausal women.

Objective: To investigate the changes in vaginal microbiota in postmenopausal women from Xinjiang, China, with high-risk human papillomavirus (HPV) infection, cervical squamous intraepithelial lesion, and cervical cancer (CC). Methods: This study enrolled healthy postmenopausal women (HC group, n=25), postmenopausal women with high-risk HPV infection (HPV group, n=25), low-grade squamous intraepithelial lesion (LSIL group, n=25), high-grade squamous intraepithelial lesion (HSIL group, n=25), and cervical cancer (CC group, n=25). DNA was extracted from vaginal secretions, and full-length 16S rRNA gene sequencing was performed on the Nanopore platform. The EasyAmplicon 2 pipeline was used for sequence processing and taxonomic annotation, PICRUSt2 was used for functional prediction, and R software was used for vaginal microbiota diversity and statistical analyses. Results: Among five groups of postmenopausal women, Shannon and Simpson alpha diversity indices were comparable, whereas Chao1/ACE richness differed significantly ( Conclusion: Vaginal microbiota undergoes progressive dysbiosis during the progression from high-risk HPV infection to CC in postmenopausal women. Distinct microbial alterations are observed at each disease stage, with substantial functional remodeling occurring at the LSIL stage. These findings provide a reference for early intervention and research on microbial biomarkers.