Analysis Of Risk Factors And Predictive Values Of Residual Or Recurrent Lesions In Patients With HSIL After LEEP

Objective: To explore the risk factors related to the residual or recurrent lesions of the cervical high-grade squamous intraepithelial lesion patients undergoing loop electrosurgical excisional procedure,and further evaluation of meaningful risk factors’ predictive values can help clinicians find early detection of high-risk patients with residual or recurrent lesions after surgery,conducting close follow-up and timely intervention and treatment.Methods: In this study,cervical biopsy or cervical canal curettage were performed in in Yuebei People’s Hospital from January 2016 to December2019.Patients with HSIL,confirmed by histopathology underwent cervical LEEP operation in the department of gynecology of our hospital,and were followed up for at least one year.The clinical data of the patients were collected by electronic case system or telephone and retrospectively studied.Results: A total of 310 patients with HSIL were divided into two groups according to the follow-up results: no residue / recurrence group(n = 279)and residue/ recurrence group(n = 31).Through the comparison between the non-residue /recurrence group and the residue / recurrence group,the results are as follows: 1.The results of univariate analysis showed that the age,menopausal status,preoperative human papillomavirus multiple infection,positive postoperative pathological margin,postoperative pathological involvement of glands,postoperative persistent infection of HPV for the first time and abnormal results of postoperative thin layer liquid-based cytology were significantly correlated with the residue or recurrence of postoperative LEEP in HSIL patients.There was no significant difference in the number of pregnancies,parturition,preoperative HPV infection,preoperative HPV16 or 18 infection,preoperative TCT results and postoperative pathological grade of LEEP.two 。 2.Multivariate binary logistic regression analysis showed that positive postoperative pathological margin,postoperative pathological involvement of glands,postoperative persistent HPV infection for the first time and abnormal results of any postoperative TCT examination were independent risk factors for residual or recurrent lesions in HSIL patients after LEEP,and the difference was statistically significant.The area under the(ROC)curve of the subjects’ working characteristics calculated by multivariate binary logistic regression model was 0.882.It shows that its predictive value is good.3.Postoperative pathological margin status,combined evaluation of HPV and TCT had the highest sensitivity(93.5%)and negative predictive value(98.9%),which was helpful for early detection of postoperative residual or recurrent lesions.Conclusions:1.Positive postoperative pathological margin,postoperative pathological involvement of glands,postoperative persistent HPV infection and abnormal TCT results after operation are independent risk factors for residual or recurrent lesions in patients with HSIL after LEEP,which have good predictive value.2.Postoperative pathological margin status,combined evaluation of HPV and TCT are helpful for early detection of residual or recurrent lesions.