Analysis Of Influencing Factors Of Residual Lesion After Conization Of Cervical Squamous Intraepithelial Lesion

Objective:To analyze the influencing factors of residual lesion of cervical squamous intraepithelial lesion after loop electrosurgical excision procedure(LEEP),and evaluate the predictive value.Methods:From January 2016 to January 2020,131 cases of patients with High-grade squamous intraepithelial lesion(HSIL)were collected from The First Hospital of Shanxi Medical University,whom were treated with LEEP and underwent hysterectomy within six months.Counted the residual lesion,screened the related factors,and evaluated the predictive value by Receiver Operating Characteristic curve(ROC curve).Results:1.Among the 131 patients,55 patients were found to have residual lesions.The rate of residual lesion was 42.0%(55/131),and 3(2.3%)cases were cervical cancer,all of which were stage IA1.2.Univariate analysis showed that endocervical curettage(ECC),pathological grade of LEEP,type of transformation zone and margin status were related to the residual lesion after LEEP(P<0.05).3.Multivariate analysis showed that both transformation zone type Ⅲ(OR=3.28,P<0.05)and positive margin(OR=3.39,P<0.05)were independent risk factors of residual lesion.4.Draw the ROC curve with the type of transformation zone as a predictor of residual lesions after LEEP,and the Area under curve(AUC)was 0.636;Draw the ROC curve with the margin status as a predictor of residual lesions after LEEP,and the AUC was 0.676;Draw the ROC curve with the ECC as a predictor of residual lesions after LEEP,and the AUC was 0.685.The results showed that the three predictors had low predictive values of residual lesion after LEEP.When the type of transformation zone was combined with the margin status,AUC increased to 0.734,indicating that the combination of the two predictors could improve the predictive value.Conclusion:1.Transformation zone type Ⅲ and positive margin were independent risk factors of residual lesion.2.When the type of transformation zone and the margin status were treated independently as the predictors of residual lesion after LEEP,the predictive value is low.The combination of the two predictors can improve the predictive value and the conclusion can be used as a reference for the management of HSIL patients after LEEP.