The Related Factors Analysis Of Residue In CINⅢ Patients Performed Total Hysterectomy After Cervical Cone Cutting

Objective:To explore the cervical intraepithelial neoplasia Ⅲ level(cervical intraepithelial neoplasia,CIN Ⅲ)in patients with cervical cone cutting line after all associated lesions residue after hysterectomy and high risk factors which will guide the clinical diagnosis and treatment of patients with cervical intraepithelial neoplasia after cervical cone resection.Methods:In September 2016 to 2018 were retrospectively analyzed in December in jilin university second hospital of obstetrics and gynecology hospital treated by CINⅢ line again after the cervical cone cutting line all the clinical data of 280 patients of hysterectomy,collect demographic data,disease history,cervical lesions in patients with medical cause and the treatment process,preoperative human papilloma virus(human papilloma virus get HPV),liquid based cytology(thinprep cytology test TCT)as a result,Age,menstrual history,pregnancy history,contraception history,smoking history,surgical methods and pathological data may have an impact on the residual lesions.All patients were divided into non-residual lesion group and residual lesion group according to the residual lesion after total hysterectomy.The non-residual lesion group included chronic cervicitis,squamous epithelial hyperplasia and no SIL tissue residue.Residual lesion group includes CINⅠ,CINⅡ,CINⅡ and CINⅢ,CINⅢ,whether involving the glands and the composition of carcinoma in situ,not including invasive lesions.The differences of the influencing factors between the residual group and the non-lesion residual group were compared,and the factors that may affect the postoperative residuals were statistically analyzed.The data were collected and organized using the office2010 EXCEL form,using SPSS22.0 software.Statistical analysis was performed to perform normality test or nonparametric test on quantitative data,chi-square test(c2 test)for qualitative data analysis,and binary logistic regression analysis for variables with statistical significance of chi-square test.Independent risk factor;P=0.05 was used as the test level in the above statistical analysis,and the difference was considered statistically significant when P < 0.05.Results:A total of 280 patients were included in this study,including 159 patients(56.79%)in the group without lesion residue after total hysterectomy and 121 patients(43.21%)in the group with lesion residue.The results of the normal test table showed that age,age of menarche,age of marriage and childbearing,number of pregnancies,and number of menopause months all did not obey the normal distribution.The P values of age,age of marriage and childbearing,age of menarche,number of pregnancies,and number of menopause months in the non-parametric test statistical scale were all greater than 0.05,with no statistical difference.Single factor analysis showed that found the reason of typical contact hemorrhages in patients with postoperative residual disease lesions at a rate of 66.7%,type HPV16/18 patients postoperative residual lesions at a rate of 56.3%,HPV loads acuity postoperatively in patients with 200 RLU lesions residue rate was 43.2%,the department of liquid based cytology acuity postoperatively in patients with ASC-H lesions residue rate was 50.4%,the cone cutting lesions pathologic HSIL/CINⅢgrade lesions residue rate was 47.9%,the residual rate of the above factors lesions were higher than in its relative group,the difference was statistically significant(P < 0.05),the cone cutting residues of risk factors for postoperative lesions;Multivariate regression analysis showed typical contact bleeding(OR=2.971,95% CI 1.345-6.565,P=0.007),HPV loads≥200RLU(OR=1.853,95% CI 1.113-3.085,P=0.018),liquid base Cytological examination≥ASC-H(OR=1.735,95% CI 1.041 ~ 2.893,P=0.035),conical lesion pathology≥HSIL/CINⅢ(OR=4.160,95% CI 1.731~10.000,P=0.001)is a cone Independent risk factors for residual lesions after excision.Conclusion:Conduit lesion pathology≥HSIL/CINⅢ,typical contact bleeding in the cause,HPV loads≥200RLU,liquid-based cytology≥ASC-H is an independent risk of residual hysterectomy after conization of CINⅢ patients factor.