| Background and Objective: In recent years,the incidence of cervical cancer increases year by year,the age of onset is the trend of younger.Cervical intraepithelial neoplasia(CIN)can progress to cervical cancer in 10-20 years if untreated.Cervical lesions can be found as early as possible through the screening of cervical cancer,and intervention and treatment as early as possible can reduce the incidence of cerivcal cancer.Biopsy under colposcopy is a key step in cervical cancer screening,its accuracy affects the screening result.The American Society for Colposcopy and Cervical Pathology,ASCCP pointed out that when the colposcopy results are satisfactory,patients with fertility requirement can be treated with conization of cervix.The limitation of cervical conization could result in residual lesion or relapse.To guide the clinical diagnosis and treatment,we studied the factors of residual lesions in cervix after conization in patients with CIN and microinvasive cervical cancer.Methods:1.Collect the clinical data of 1889 patients with CIN who received further surgery during 2013-2015.All patients underwent colposcopic multiple biopsy before operation.Contrast the colposcopy biopsy pathology with postoperative pathology of the patients to analyze the corresponding rate of colposcopic multiple biopsy.2.A retrospective analysis of the clinical data of 267 patients with CIN or suspicious of Microinvasive carcinoma(MIC)who received further surgery within six months after conization during2011-2015.In univariate analysis,the measurement data are analyzed by variance and the comparison among groups of enumeration data are tested by chi-square.Multivariable effect was determined by Logistic regression analysis.Result: 1.Contrast the colposcopy biopsy pathology with postoperative pathology of 1889 patients.The results show corresponding rate of colposcopic multiple biopsy is90.02%.2.74 out of the 267 patients residual lesions in cervicx after conization.Univariate analysis showed that lesions involving the glands(p = 0.003),3-4 quadrants involved(p=0.006)and positive resection margin(p=0.002)were significant factors associated with residual lesions.In multivariable logistic regression only the positive resection margin(p=0.022)was an independent risk factor of residual lesion after conization.Conclusion:1.The limitation of colposcopic multiple biopsy in the diagnosis of CIN is confirmed.Combined colposcopic multiple biopsy with conization of cervix would make a more correct diagnosis of CIN.The corresponding rate of colposcopic multiple biopsy is higher when it is used for diagnosis of CINⅢ than CINⅡ.2.The grade of the cervical lesion,lesions involving the glands,3-4 quadrants involved and positive resection margin were significant factors associated with residual lesions,While positive resection margin was the only independent risk factor of residual lesions after conization. |
