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Published on: February 16, 2024
[Prognostic factors of cervical high-grade squamous intraepithelial lesions treated by cold knife conization with
Qing-wei Meng1, Zhen-he Qin, Ying Mao
1Department of Obstetrics and Gynecology, Beijing Hospital, Ministry of Health, Beijing 100730, China.
Objective:
To investigate the prognostic factors of cervical high-grade squamous intraepithelial lesions treated by cold knife conization with negative margin.
Methods:
Two hundred and sixty-six women with cervical high-grade squamous intraepithelial lesions treated by cold-knife conization with negative margins at Beijing Hospital between Jan 1999 and Jan 2004 were analyzed retrospectively. All patients were followed up with cytology, high-risk human papillomavirus (HPV) test and colposcopy if necessary.
Results:
The cervical CIN recurrence rate was 8.6% with no incidence of invasive cervical cancer after a median follow-up of 46 months. The recurrence was related to the grade of lesions and gland involvement pathologically. One of 20 (5.0%) cases with cervical intraepithelial neoplasia (CIN) II, 9 of 164 (5.5%) cases with CIN III (excluding carcinoma in situ, CIS) and 13 of 82 (15.8%) cases with CIS recurred (P < 0.05). Seven of 40 (17.5%) cases with gland involvement and 16 of 226 (6.0%) cases without gland involvement recurred (P < 0.05). High-risk HPV tests were performed in 257 of 266 cases before surgery. Twenty one of 244 cases (8.6%) with positive high-risk HPV recurred and none of 13 cases with negative test recurred.
Conclusions:
There are few recurrences for cervical high-grade squamous intraepithelial lesions treated by cold knife conization with negative margins. Close follow-up is needed for those high grade lesions and those with gland involvement.
