Analysis of risk factors for residual lesion of HSIL after loop electrosurgical excision procedure / 中国实用妇科与产科杂志

ABSTRACT

OBJECTIVE: To analyze clinical outcome of high-grade squamous intraepithelial lesion(HSIL)half a year after loop electrosurgical excision procedure(LEEP).METHODS: The retrospective study was carried out on 752 patients who underwent LEEP,with HSIL in the LEEP histopathology from January 2018 to December 2018 at Shanghai First Maternity and Infant Hospital Affiliated to Tongji University to confer the difference between residual group and non-residual group after 6 months of the LEEP conization.TCT,cervical biopsy and high risk HPV test were performed on all patients.RESULTS: Among 752 cases,57(7.6%)cases suffered HSIL residual disease while 695 cases in non-residual group. Before LEEP,HR-HPV 16/18 positive were less in HSIL lesion group showed no difference than those in non-residual group(P>0.05).The residual rate of post-LEEP specimens:CIS and invasive cancer identified only microscopically was higher than that in the AIS group(P<0.05).After LEEP,238 cases with positive margins and 514 cases with negative margins.The residual rate in patients with positive margin and negative margin were 21.1% and 1.4%,(P<0.05).The residual rate in patients with positive endocervical margin,ectocervical margin,unilateral margin and fibrous margin were28.7%,18.9%,17.2% and 26.3%,respectively(P<0.05). The residual rate in patients with second LEEP and non-second LEEP were 29.7% and 6.4%,respectively(P<0.05).The residual rate in patients with TCT≥ ASCUS and normal were 21.9% and 4.4%,respectively(P<0.05).Multivariate regression analysis using the logistic regression model showed CIS,abnormal cytology TCT≥ ASCUS and LEEP with positive margins to be independent risk factors for residual lesions after LEEP(P<0.05).CONCLUSION: Histopathology CIS after LEEP,abnormal cytology(TCT≥ ASCUS)and positive margin are predictors of residual lesion after LEEP with HSIL.