The Management For The Patients With Highgrade Squamous Intraepithelial Lesion With Positive Margin By Conization

Objective:To discuss the managementof the patients with high-grade squamous intraepithelial lesions with positive margins by conization.Methods:Clinic-pathological data of 119patients who underwent subsequent surgery for high-grade squamous intraepithelial lesions with positive margins by conization from January 2009 to December 2014 who received repeat conization were retrospective collected and analyzed.Result:After subsequent surgery, there were 56 (47.06%) patients with residual disease, of whom fourhad invasive cervical carcinoma, three cases of IA1 cervical squamous carcinoma and only one case of IA 2 cervical squamous carcinoma. Univariate analysis showed that age>35 years (P=0.005),menopause>5 years (P=0.035), cervical lesions involved multiple quadrants margins (P=0.001)were related with residual disease. Multivariate analysis revealed that only involved multiple cervical margins quadrants OR3.701 (95CI%:1.496-9.154) were significant factors associated with residual disease.Conclusions:1. The neoplasia residual rate of high-grade squamous intraepithelial lesions with positive margins by conisation was only 47.06%, the subsequent processing may not be routine conizationagain.2. Positive margin involvementmultiplequadrants was the independent risk factors for lesion residual. When the factor exists, it is recommended to repeat conization for high-grade squamous intraepithelial lesions with positive margins by conisation; otherwise evaluate after 4-6months of initial conization, and then decide how to deal with them.