Analysis of risk factors of positive surgical margin and residual lesions after cone resection of high-grade intraepithelial neoplasia

Abstract

Objective To analyze the risk factors of positive surgical margin and residual lesions after cone resection of high-grade intraepithelial neoplasia, and to guide clinical work and follow-up. Methods The clinical data of 180 patients with cervical epithelial neoplasia of grade Ⅱ and Ⅲ who underwent cervical conization in the People's Hospital of Inner Mongolia Autonomous Region from November 2013 to November 2018 were retrospectively analyzed.The risk factors associated with residual margin and reoperation (including re-cone and hysterectomy) after conization were performed by single factor and multivariate regression analysis. Results The incidence of positive resection margins after conization was 31.67%(57/180), which of the residual margin of re-surgery was 36.84%(21/57). Menopause, contact bleeding, cervical cancer(in situ carcinoma, microinvasive carcinoma) were positive risk factors for conical cutting margin (OR=2.342, 2.428, 8.949). Contact bleeding, cervical cancer(in situ carcinoma, microinvasive carcinoma) were risk factors for residual resection of the surgical margin after conization (OR=5.370, 10.992). Conclusion Contact bleeding, cervical carcinoma in situ, microinvasive carcinoma are closely related to cervical margin and lesion residual.Among them, menopause is also positively related to margin, which is a risk factor affecting cervical cone cutting margin and residual reoperation.It should be highly valued in clinical. Key words: Cervical intraepithelial neoplasia; Conization; Reoperation; Regression analysis; Risk factors