Related Factors For Pathological Changing In Patients With Cervical Intraepithelial Neoplasia Grade1after Loop Electrosurgical Excision Procedure

ObjectiveTo investigate the related factors for pathological changing in patients withcervical intraepithelial neoplasia grade1(CINⅠ) diagnosed by colposcopic biopsytreated by loop electrosurgical excision procedure (LEEP).Materials and MethodsFrom January2009to December2011, the patients with cervical diseases werecollected in The First People’s Hospital in Guangzhou. One hundred and forty-fourpatients with the diagnosis of Thinprep Cytology Test (TCT) of high gradesquamous intraepithelial lesion (HSIL) or atypical glandular cell of undeterminedsignificance (AGC-US), diagnosed CINⅠ by colposcopically directed biopsy wereretrospectively studied. These patients were accepted high-risk humanpapillomavirus (HR-HPV) test and treated by LEEP shortly, to compare thepathological results of colposcopic biopsy and LEEP. SPSS13.0statistical softwarewas used for statistical analysis on all data about the age, the results of TCT, the results of HR-HPV, cervical-gland corroded lesions and existed multi-focus.Statistical analysis was performed by χ2test to analyze the pathological resultsupgraded after LEEP. P<0.05has statistically significant.Results1. The pathological coincidence of colposcopic biopsy and LEEP was73.61%. Theproportions were15.97%,57.64%and26.39%from patients with chroniccervicitis, CINⅠ, pathological upgraded (CINⅡ and CINⅢ) after LEEP.2. The positive rate of HR-HPV in the cases of pathological results upgraded afterloop electrosurgical excision procedure was100%. There was significantdifference in positive rate of HR-HPV between low-grade cervical lesions andhigh-grade cervical lesions (P<0.01), and the difference increased with theaggravation of cervical lesions.3. The positive types of HR-HPV were HPV16,18,45,52,58, and the other types ofHR-HPV were negative. There was significant difference in positive rate ofHPV16and HPV18between low-grade cervical lesions and high-grade cervicallesions (P<0.05). However, There was no significant difference in positive rate ofHPV45,52and58between low-grade cervical lesions and high-grade cervicallesions (P>0.05).4. The pathological upgraded were significantly higher in the patients with aged≥35years, positive for HR-HPV, cervical-gland corroded lesions and existedmulti-focus (P<0.05).Conclusions1. Miss diagnosis of high grade cervical lesions may still exist on CINⅠ bycolposcopically directed biopsy.2. It should be alert that there may exist high grade cervical lesions on the casesbeing diagnosed CINⅠ by colposcopically directed biopsy with cytologic HSILor AGC-US.①The anatomical characteristics of cervical;②Cytological diagnosis of HSIL or AGC-US;③Aged≥35years;④Positive forHR-HPV,especially the positive for HPV16or HPV18;⑤Cervical-glandcorroded lesions;⑥Existed multi-focus are the significant factors in thepathological upgraded after LEEP in patients with cervical intraepithelialneoplasia grade1, so the patients with any above②-⑥factor should be treatedactively by LEEP.3. The positive rate of HR-HPV was different from low-grade cervical lesions andhigh-grade cervical lesions, and the difference increased with the aggravation ofcervical lesions. When patients with CINⅠare positive for HPV16or HPV18,we should be on the alert that the high grade cervical lesions may exist.4. With the related factors of miss diagnosis, the colposcopic biopsy on diagnosis ofCINⅠ is less accurate than LEEP, which is more accurate to diagnose and treatthe patients with cervical intraepithelial neoplasia.