An Analysis On The Factors Related To Recurrence Of High-grade Squamous Intraepithelial Lesion

Objective:This study aims to assess the factors related to recurrence of high-grade squamous intraepithelial lesion (HSIL) with negative margin of conization.Methods:A retrospective review of 66 patients admitted to our hospital with recurrence of HSIL with negative marginof conization from June 1st,2010 to May 31st,2015. A 1:2 matched case-control study was conducted to analysis whether age, menopausal status, delivery times, combined complaints, hrHPV infection, cervical cytology results, glands involvement, multiple-quadrant involvement, positive endocervical curettage and lesions scope were the factors related to recurrence of HSIL with negative margin of conization.Results:The age of the patients in recurrence group ranged from 23 to 69 years (median at 46). The recurrence interval ranged from 4 to 72 months (median at 12) after initial conization. There were 72.7% patients older than 40 years in the recurrence group and 54.5% in the control group relatively. Univariate analysis showed that age older than 40 years was related to the recurrence of HSIL after cervical conization (OR= 2.286, P= 0.014< 0.05). The proportion of cytological ASC-H or HSIL was 66.7% in the recurrence group and 46.9% in the control group relatively. Univariate analysis showed that cytological ASC-H or HSIL was related to the recurrence of HSIL after cervical conization (OR= 2.652, P= 0.007< 0.05). Multivariate analysis showed that the age older than 40 years and the cytology results of ASC-H or HSIL were identified as independent factors related to recurrence of HSIL with negative margin of conization. Conclusion:The recurrence of HSIL with negative margin of conization was 1.4% in this study. There were 31.8% of patients relapsing after 2 years. It is suggested that a continuous long-term follow-up cannot be ignored after cervical conization for HSIL even with negative margin. Age older than 40 years and cytology of ASC-H or HSIL were independently associated with recurrence of HSIL.Strengthening postoperative follow-up is necessary for patients with each factor.