title: Residual disease and risk factors in patients with high-grade cervical intraepithelial neoplasia and positive margins after initial conization.
abstract: BACKGROUND
  The purpose of this study was to determine the clinicopathologic predictors of residual disease in patients with high-grade cervical intraepithelial neoplasia (CIN) and margin involvement after initial conization.
  
  
  METHODS
  Data from 145 patients who underwent subsequent surgery for high-grade CIN with positive margins were retrospectively analyzed.
  
  
  RESULTS
  After subsequent surgery, residual disease was diagnosed in 47 (34.2%) patients, of whom five had invasive cervical carcinoma, 31 had CIN 3, nine had CIN 2, and two had CIN 1. Multivariate analysis revealed that only age ≥35 years (P=0.033), major abnormal cytology (P=0.002), and pre-cone high-risk human papillomavirus load ≥300 relative light units (P=0.011) were significant factors associated with residual disease.
  
  
  CONCLUSIONS
  Age ≥35 years, major abnormal cytology, and pre-cone high-risk human papillomavirus load ≥300 relative light units were the only significant factors predicting post-cone residual disease. Appropriate application of these predictive factors may avoid delayed treatment and overtreatment.
authors.affiliation: Department of Gynecology, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, People's Republic of China ; Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Second Hospital of Shandong University, Jinan, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Suwen
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Gynecology, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, People's Republic of China ; Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Gynecology, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, People's Republic of China ; Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Lü
keywords: cervical intraepithelial neoplasia; conization; positive margin; predictor; residual disease