[Prognostic factors of cervical high-grade squamous intraepithelial lesions treated by cold knife conization with negative margin].
OBJECTIVE
To investigate the prognostic factors of cervical high-grade squamous intraepithelial lesions treated by cold knife conization with negative margin.


METHODS
Two hundred and sixty-six women with cervical high-grade squamous intraepithelial lesions treated by cold-knife conization with negative margins at Beijing Hospital between Jan 1999 and Jan 2004 were analyzed retrospectively. All patients were followed up with cytology, high-risk human papillomavirus (HPV) test and colposcopy if necessary.


RESULTS
The cervical CIN recurrence rate was 8.6% with no incidence of invasive cervical cancer after a median follow-up of 46 months. The recurrence was related to the grade of lesions and gland involvement pathologically. One of 20 (5.0%) cases with cervical intraepithelial neoplasia (CIN) II, 9 of 164 (5.5%) cases with CIN III (excluding carcinoma in situ, CIS) and 13 of 82 (15.8%) cases with CIS recurred (P < 0.05). Seven of 40 (17.5%) cases with gland involvement and 16 of 226 (6.0%) cases without gland involvement recurred (P < 0.05). High-risk HPV tests were performed in 257 of 266 cases before surgery. Twenty one of 244 cases (8.6%) with positive high-risk HPV recurred and none of 13 cases with negative test recurred.


CONCLUSIONS
There are few recurrences for cervical high-grade squamous intraepithelial lesions treated by cold knife conization with negative margins. Close follow-up is needed for those high grade lesions and those with gland involvement.
Meng
Qing-wei
QW
Department of Obstetrics and Gynecology, Beijing Hospital, Ministry of Health, Beijing 100730, China.
Qin
Zhen-he
ZH
Mao
Ying
Y
Zhao
Xiao-dong
XD
D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D019092:Conization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*