The Influencing Factors Of Recurrence Of High-Grade Cervical Intraepithelial Neoplasia After Cold Knife Conization

Objective: To investigate the influencing factors of recurrence of high-grade cervical intraepithelial neoplasia(HSIL)after cold knife conization.Method: A retrospective cohort study was conducted to analyze 269 patients who underwent cold knife conization for HSIL in the First Affiliated Hospital of China Medical University from January 2015 to September 2017.According to the pathology of preoperative cervical biopsy or postoperative pathology,the patients were divided into involving-gland group(n=94)and non-involving-gland group(n=175).Follow-up began in July 2015 and continued until January 2019,and the ending was recurrence,which was to construct survival curves and compare.Cox regression analysis was used to investigate the effects of such factors as involving gland,CIN grade,age of first diagnosis,age of first sexual experience,high-risk HPV infection and cervical involvement range on recurrence after cervical cold knife conization.Result: Cox regression analysis showed that CIN grade,age of first diagnosis,age of first sexual experience,high-risk HPV infection and cervical involvement range had no effect on the prognosis of HSIL patients(P > 0.05),while the involving glands were the risk factors for postoperative recurrence of HSIL patients(P < 0.05),and the risk of postoperative recurrence was 3.013 times that of the non-involving-gland group.Conclusion: The cervical intraepithelial neoplasia glands are the risk factors for recurrence after cervical cold knife conization,which will increase the recurrence rate.According to the increase of surgical depth,the risk of recurrence may be reduced,so close re-examination should be conducted for these patients after surgery to reduce the risk of lesion progression.