Study On Related Factors Of Positive Incisal Margin After Cold Knife Conization

Objective:Through retrospective analysis of the patients who underwent cervical cold knife conization(CKC)in Baoding First Central Hospital,the factors affecting the positive pathological margin after cervical cold knife conization(CKC)were discussed.Methods:The clinical data of 864 patients who underwent cervical cold knife conization because of the presence of HSIL in Baoding first Central Hospital from January 2014 to May 2021 were selected.according to the postoperative pathological margin status,the patients were divided into two groups: positive and negative.The single factors affecting the positive margin of cervical cold knife conization included age,menopausal state,history of pregnancy and delivery,preoperative HPV infection,TCT,disease variables of biopsy,lesion grade,cone height,external caliber,operator’s qualification,involvement of glands and cervical squamous epithelium thickness,and further multivariate analysis.The difference was statistically significant(P<0.05).Results:1.Of the 864 patients who met the inclusion criteria,148 had a positive margin with a positive rate of 17.10%.2.In univariate analysis,age ≥ 50 years old,menopause,pregnancy ≥ 2times,birth ≥ 2 times,lesion grade,and involvement of glands were the high-risk factors affecting positive surgical margins(P<0.05),TCT lesion degree,whether HPV infection,HPV infection type,biopsy lesions,operator qualifications,cone height,external diameter,cervical squamous epithelial thickness has not associated with positive margin(P>0.05).3.Cervical squamous epithelial thickness is related to the lesion grade and thinning as the lesion grade increases.4.In multivariate analysis,menopause,pregnancy ≥ 2 times,and lesion grade CINII or above were independent risk factors for positive surgical margins after conization(P<0.05).Conclusions:Menopause,pregnancy ≥ 2 times,and lesion grade CINII or above are independent risk factors that affect positive surgical margins after conization.Therefore,patients have these high-risk factors,and preoperative attention should be paid to them.The scope and depth of conization should be guided according to specific circumstances,in order to reduce the incidence of positive surgical margins after conization.