Diagnosis value of LEEP and analysis of postoperative risk factors for residual disease following LEEP

Objective To discuss the value of loop electrosurgical excision procedure(LEEP) and assess the risk factors of residual disease of cervical intraepithelial neoplasia Ⅲ(CIN Ⅲ) and Ia1 after LEEP.Methods The medical records of biopsy,LEEP and pathology of hysterectomy within 1 month after LEEP were retrospectively analyzed in 52 patients with CIN Ⅲ and Ia1.The diagnosis of LEEP and the relationship between residual disease and excision margin,high risk human papilloma virus(HPV) before LEEP were investigated.Results The rates of residual disease in the cases with positive and negative margins were 57.7% and 34.6%)(P0.05).The median HPV load before LEEP in 52 cases with no residual disease(28/52) was 28.82,which was significantly lower than 640.97 in those with residual disease(P0.05).The ROC curve showed that when the margin was negative and HR-HPV≤64.11,the negative predictive value is 100%,and when the margin was positive and HR-HPV17.59,the positive predictive value was 66.7%.Conclusion Cervical squamous cancer in stages of CIN and Ia1 has a feature of multilesions coexistence.Examining the HPV load before LEEP and excision margin is helpful in managing cervical squamous cancer in stages of CIN Ⅲ and Ia1.