Clinical analysis of cervical cold knife conization for the diagnosis and treatment of 347 patients with cervical intraepithelial neoplasia 2/3

Objective To evaluate the value of cervical cold knife conization(CKC)in the diagnosis and treatment of cervical intraepithelial neoplasia(CIN)2/3and investigate the high-risk factors for residual lesions.Methods Data of 347 cases underwent CKC were retrospectively analyzed.Association of residual lesion and resection margin status and glandual involvement was analyzed to investigate the outcomes of cervical CKC.Results The accordance rate of pathology between conization and biopsies was 25.5% in 47 patients with CIN2,of whom the pathological results were upgraded in 22cases(46.8%)and 2(8.0%)cases were diagnosised as invasive cervical cancer.The accordance rate of pathology between conization and biopsies was 63.3%%in 300 patients with CIN3,of whom the pathological results were upgraded as invasive cervical cancer in 2(8.0%)cases.Hysterectomy was performed in 122 cases with CIN3,residual lesion occurred in 31(25.4%)cases,and 19(15.6%)cases downgraded.Residual lesions were found in 62.5%cases(5/8)with positive margins,which was higher than 22.8%(26/114)cases with negative margins(P0.05).The residual lesions were seen in 26.4% cases with glandual involvement and in 22.9% cases without glandual involvement(P0.05).Conclusion Cervical CKC has an important value in the diagnosis and treatment of CIN 2/3.The positive margin is probably a high-risk factor for residual lesion,while glandual involvement has no correlation with it.