| Objective: To compare the pathological reports of patients with cervical multi-point biopsy diagnosed as cervical intraepithelial neoplasia(CIN)grade 3 and undergoing cervical conization,and to explore the factors related to postoperative pathological results upgrade to cervical cancer.It is hoped that clinically,multi-point biopsy of the cervix will provide a targeted treatment plan for CIN3 patients.Methods: Strictly following the inclusion and exclusion criteria of this study,we screened patients whose diagnosis and treatment period was from September 2017 to September 2020 in the Affiliated Hospital of Guilin Medical University who had a CIN 3 pathology through multi-spot biopsy of cervical tissue under colposcopy,as well as those from other hospitals who passed our hospital.Patients whose pathological results were CIN3 after the consultation in the pathology department were all patients who underwent cervical conization in our hospital for the first time as the research subjects.According to whether the pathological results of the patients’ conization specimens were upgraded to cervical cancer,the collected patients were divided into two categories.Group: The pathological result is a cancer-promoted group and the pathological result non-cancer non-promoted group.The basic conditions of patients who may affect the postoperative pathological upgrade to cancer,whether there are contact bleeding,pregnancy times,parity,menopausal status,thin-layer liquid-based cytologic test(TCT)results,human papilloma Virus(human papilloma virus,HPV)results,squamous cell carcinoma antigen(SCCA),colposcopy results,cervical biopsy pathological results,whether the lesion involves glands,pathological results after conization,etc.Single factor analysis was performed,and binary logistic regression analysis was performed on the single factor with statistical significance.Results: A total of 672 patients with cervical multi-spot biopsy results of CIN3 were included in this study.56 patients were upgraded to cervical cancer after the initial cervical conization,and the upgrade rate was 8.3%(56/672).Cervical cancer stage is greater than or equal to IA2 stage 27 cases;univariate analysis results show: patient’s age,menopausal status,squamous cell carcinoma antigen SCCA≥1.5ug/L,TCT result is high-grade squamous intraepithelial lesions(high-gradesquamous intraepithelial Lesions,HSIL),atypical squamouscell-cannot exclude high-grade squamous intraepithelial lesions(ASC-H),atypical glandular epithelial cells(AGC),contact hemorrhage,parity ≥2 Second,the result of colposcopy was cervical transformation zone type III,and biopsy pathology suggested that the lesion involved glands was a risk factor for the pathological upgrade of cervical conization after cervical multi-point biopsy to cancer(P<0.05).After performing binary logistic regression analysis on statistically significant single factors,it is concluded that SCCA≥1.5ug/L,TCT results suggest HSIL,ASC-H,AGC,contact bleeding,biopsy lesions involving glands,colposcopy results are cervical transformation zone III Type is an independent risk factor for the pathological upgrade of patients to cervical cancer after the initial conization of the cervix(P<0.05).Conclusion:(1)For patients with cervical biopsy as CIN level 3,the probability of pathological upgrade to cancer after the initial cervical conization increases with age.(2)SCCA≥1.5ug/L,preoperative TCT result is HSIL,ASC-H,AGC,contact bleeding,biopsy lesions involving glands,colposcopy result is cervical transformation zone Type III is an independent risk factor for the pathological results of patients with CIN level 3 to upgrade to cervical cancer after the initial conization of the cervix.(3)In clinical work,patients whose cervical biopsy pathology is CIN3 should not be treated with extrafascial hysterectomy alone,and diagnostic conization should be performed.According to the postoperative pathological results and the patient’s age,postoperative follow-up or hysterectomy may be performed. |
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