Analysis of the curative effect of individualized quantitative cervical conization for cervical squamous intraepithelial lesion by insufficient colposcopy
Objective To analyze the curative effect of individualized quantitative cervical conization for cervical squamous intraepithelial lesion(SIL)by insufficient colposcopy.Methods 192 perimenopausal and postmenopausal women with SIL by insufficient colposcopy were involved in the study,whose length of cervical canals was all measured by B-mode ultrasound before operation.Then they were conducted with individualized quantitative cervical conization,including 108 cases of cold-knife conization(CKC)and served as the CKC group,and 84 cases of loop electrosurgical excision procedure(LEEP)and served as the LEEP group.52 patients whose pathology were diagnosed as high-grade squamous intraepithelial lesion(HSIL)were performed with extrafascial hysterectomy or additional hysterectomy.The single factor of positive margins after cervical conization and the residual cervical pathology after extrafascial hysterectomy or additional hysterectomy for HSIL were analyzed.Results 35 of 192 SIL patients had positive margins after cervical conization,of which the postoperative margin positivity rate of the CKC group was 18.52%(20/108),and that of the LEEP group was 17.86%(15/84).There was no significant difference in postoperative margin positivity rate between the two groups(P>0.05).Univariate analysis showed that the percentage of lesions involving glands was 65.71%(23/35)in margin-positive patients,which was higher than 43.95%(69/157)in margin-negative patients(P<0.05).There was no statistically significant difference in the comparison of surgical methods,high-risk human papillomavirus(HPV)infection,cytology,and colposcopic pathology grade between margin-positive patients and margin-negative patients(P>0.05).Additional surgeries were performed in 52 patients with pathology of HSIL after cervical conization,42 cases had the requirement or indication for hysterectomy and additional extrafascial hysterectomy was performed,including 18 cases in the CKC group and 24 cases in the LEEP group.In the remaining 10 cases,cervical conization was performed on positive sites according to postoperative pathology,including 7 cases in CKC group and 3 cases in LEEP group.There was no statistically significant difference in the residual cervical positivity rate between the CKC group and the LEEP group after additional surgery(P>0.05).Conclusion There is no significant difference in SIL efficacy between the two methods of individualized quantitative cervical conization to treat perimenopausal and postmenopausal women with SIL by insufficient colposcopy.Therefore,LEEP is a practical therapy for those who require to retain their uterine.
万方数据
维普
