Meta-Analysis Of High Risk Factors For Residual Lesions In Patients With Positive Margin After Cervical Cone Resection

Objective To comprehensively evaluate the residual related factors in patients with positive margins after cervical conization by Meta-analysis,looking for high-risk factors with predictive value.Methods CNKI,VIP,Wanfang Database,CBM,Pubmed,Embase,and Cochrane Library were used to collect related articles about the residual lesions in patients with positive margin after cone resection.Two reviewers screened abstracts according to the inclusion and exclusion criteria,and evaluated the quality of included literature.Finally,five indicators(the menopause,glandular involvement,positive endocervical margin,the number of positive quadrants,and high-risk human papilloma virus(HR-HPV)load)were extracted from the literature and analyzed by Revman5.3 software.Results Thirteen articles were finally included.meta-analysis results were shown:Residual risks in patients with postmenopausal(OR=2.33,95% CI [1.75,3.10]),positive endocervical margin(OR=2.67,95% CI [1.87,3.82]),positive quadrants>2(OR= 0.15,95% CI [0.06,0.36])and HPV-DNA>300RLU(OR=3.12,95% CI [1.81,5.36])were significantly increased.However,the residual risk was no statistically significant between glandular involvement and no glandular involvement(OR=1.07,95% CI [0.70,1.65],P = 0.74).Conclusion 1.Menopause,positive endocervical margin,positive quadrants>2,HPV-DNA> 300 RLU are high risk factors for residual lesions in patients with positive margin after cervical resection.2.Gland involvement is not the high risk factor for residual lesions in patients with positive margins after cervical resection.3.If no fertility or organ preservation requirements,Surgical treatment is recommended for patientswith high risk factors for residual disease..4.Patients without high risk factors for residual disease are advised to follow up in the clinic.