Risk factor analyses of positive margins of conization specimen and post-cone residual disease in patients with cervical intraepithelial neoplasia grade 3 / 医学研究生学报

ABSTRACT

[Abstract ] Objective Positive margins of conization specimen for cervical intraepithelial neoplasia grade (CIN)3 is a high risk factor of continuous cervical lesions or progress to early invasive carcinoma .The aim of this study was to evaluate the risk factors of positive margins of conization specimen and post-cone residual disease in hysterectomy specimens following conization for CIN 3. Methods Clinical data from 218 patients with CIN 3 underwent hysterectomy after conization from 2001 to 2013 were analyzed retro-spectivly.Multi-factors logistic regression was performed to determine the independent risk factors for positive margins of conization specimen and post-cone residual disease. Results Fifty five cases(25.2%) had positive margin of conization specimen , and the independent risk factors were unsatisfactory colposcopy (OR5.18,95%CI2.49-11.10), width of conization specimen smaller than 2 cm (OR7.68,95%CI2.31-28.10) and pathology of CIN3 with carcinoma in situ (OR4.38,95%CI1.67 -12.10).Forty seven patients (21.6%) had post-cone residual disease , and the independ-ent risk factors were length of conization specimen smaller than 1.5 cm (OR2.45,95%CI1.12-5.69), pathology of CIN3 with carci-noma in situ (OR4.96,95%CI2.17-11.70) and status of coniza-tion margins (OR4.34,95%CI1.95-9.78). Conclusion The satisfaction of colposcopic examination, conization specimen di-ameters including width and length , CIN3 with carcinoma in situ and status of conization margins could contribute to positive margins of conization or residual disease in subsequent hysterectomy specimens .More attention should be paid to such a group of CIN 3 patients clinically.