Clinical Distribution Characteristics Of Cervical Intraepithelial Neoplasia And Efficacy Of Conical Cervical Resection

Objective:To investigate the clinical distribution characteristics of patients with cervical intraepithelial neoplasia(CIN),analyze the postoperative efficacy and side effects of conical cervical resection,and further guide the clinical diagnosis and treatment.Methods:From January 1,2018 to July 31,2021,patients admitted to the Third Affiliated Hospital of Southern Medical University who underwent cold knife conical resection(CKC)or loop electrosurgical excision procedure(LEEP)due to CIN in the hospital were selected,a total of 299 patients(202 patients with CKC;97 patients with LEEP).All patients underwent genital human papillomavirus(HPV),thinprep cytologic test(TCT)and colposcopy biopsy before surgery.Part I:According to the pathological results after cervical conectomy,patients were divided into high-grade squamous intraepithelial lesion(HSIL)group and low-grade squamous intraepithelial lesion(LSIL)group(HSIL:196;LSIL 103 patients),retrospectively analyzed the relationship between the patient’s medical history,pregnancy history,life history and the degree of CIN lesion,and found its high risk factors.Part II:to analyze the consistency between TCT and colposcopy biopsy pathological results before surgery with postoperative cervical conectomy pathological results respectively.Part Ⅲ:Based with postoperative pathological margin,postoperative review of HPV results,postoperative complications,doing a retrospective analysis of the relationship between preoperative related factors and postoperative efficacy.Results:1.Univariate analysis showed that the difference was statistically significant in contraceptive method and colposcopy lesion number between HSIL group and LSIL group.Multifactor analysis showed that high SCC-Ag and abnormal vaginal secretion were the risk factors for the degree of CIN,while condom contraception was the protective factor for the degree of CIN.2.TCT results showed statistically significant difference in postoperative coincidence rate between LSIL and HSIL.The results of biopsy under colposcopy before operation are consistent with the results of pathology after operation.3.There was statistically significant difference in multiple HPV infections preoperative between HPV negative conversion and continuous infection after surgery;There were statistically significant differences in menopause,TCT results,colposcopy lesion number,biopsy pathology and conical pathology between patients with positive and negative margins.In terms of postoperative complications,there were statistically significant differences in operation way.Conclusion:1.High SCC-Ag and abnormal vaginal secretion are risk factors for the pathological degree of CIN,and condom contraception is its protective factor.2.The reliability of HSIL results indicated by preoperative TCT is of greater reference significance than LSIL results.Under colposcopy,the lesion range of HSIL is wider than that of LSIL,and colposcopy biopsy is good for the diagnosis of CIN.3.Except to HPV16 and 18 positive patients,the clinical management of HPV52 and 58 positive patients should also be more active;Multiple HPV infections before surgery are prone to persistent infection after surgery,requiring close follow-up.4.Patients with menopause,TCT results of HSIL,colposcopy number of lesions>2,biopsy pathology indicated by HSIL,conical pathology indicated by CINⅢinvolved gland,postoperative conical pathological margin positive incidence is higher,clinical diagnosis and treatment needs to pay attention to select a more appropriate surgical method.CKC is more likely to cause complications than LEEP.