Risk factors of LEEP margin positivity and optimal length of cervical conization in cervical intraepithelial neoplasia

被引:1
作者
Cong, Qing [1 ]
Yu, Yi [1 ]
Xie, Yu [1 ]
Li, Yanyun [1 ]
Sui, Long [1 ]
机构
[1] Fudan Univ, Obstet & Gynecol Hosp, Cerv Dis Diag & Treatment Ctr, Shanghai, Peoples R China
来源
FRONTIERS IN ONCOLOGY | 2023年 / 13卷
关键词
LEEP; conization margins; length; transformation zone; cervical intraepithelial neoplasia; ADENOCARCINOMA-IN-SITU; MANAGEMENT; TERMINOLOGY; COLPOSCOPY; PATHOLOGY; SOCIETY;
D O I
10.3389/fonc.2023.1209811
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundThe conization length for cervical precancerous lesions is essential for treatment but is left undetermined. This study aims to explore the reasonable and optimal conization length in patients with different types of cervical transformation zones (TZs) to reach the treatment outcome of margin negative in the surgery. MethodsFrom July 2016 to September 2019, a multi-center prospective case-control study with or suspicion of cervical precancer was enrolled from five medical centers in Shanghai, China. The clinical characteristics, cytology, human papillomavirus (HPV), histopathology, and details of cervical conization were recorded. ResultsA total of 618 women were enrolled in this study; 6.8% (42/618) had positive internal (endocervical and stromal) margins and 6.8% (42/618) had positive external (ectocervical) margins of loop electrosurgical excision procedure (LEEP) specimen. Comparing the positive internal margin group with the negative group, age (p = 0.006) and cytology (p = 0.021) were significantly different. Multivariate logistic regression analysis showed that the risk factors for positive internal margin were cytology & GE; high-grade squamous intraepithelial lesion (HSIL) (odds ratio (OR) 3.82, p = 0.002) and age (OR 1.11, p < 0.001). The positive internal margin rate was 2.7%, 5.1%, and 6.9% in TZ1, TZ2, and TZ3, respectively, while the positive external margin was 6.7%, 3.4%, and 1.4%, respectively. In the TZ3 group, the HSIL positive internal margin of the 15-16-mm group (10.0%, 19/191) was significantly greater than in TZ1 (2.7%, 4/150) (p = 0.010) and TZ2 (5.0%, 9/179) (p = 0.092); when excision length increases to 17-25 mm, the positive internal margin rate dramatically decreased to 1.0% (1/98). ConclusionA cervical excision length of 10-15 mm is reasonable for TZ1 and TZ2 patients, while 17-25 mm is optimal for TZ3 excision with more negative internal margins.
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  • [11] Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines
    Egemen, Didem
    Cheung, Li C.
    Chen, Xiaojian
    Demarco, Maria
    Perkins, Rebecca B.
    Kinney, Walter
    Poitras, Nancy
    Befano, Brian
    Locke, Alexander
    Guido, Richard S.
    Wiser, Amy L.
    Gage, Julia C.
    Katki, Hormuzd A.
    Wentzensen, Nicolas
    Castle, Philip E.
    Schiffman, Mark
    Lorey, Thomas S.
    [J]. JOURNAL OF LOWER GENITAL TRACT DISEASE, 2020, 24 (02) : 132 - 143
  • [12] Cervical intraepithelial neoplasia in women with transformation zone type 3: cervical biopsy versus large loop excision
    Gustafson, Line Winther
    Hammer, Anne
    Bennetsen, Mary Holten
    Kristensen, Christina Blach
    Majeed, Huda
    Petersen, Lone Kjeld
    Andersen, Berit
    Bor, Pinar
    [J]. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2022, 129 (13) : 2132 - 2140
  • [13] Maximising the acceptability of extended time intervals between screens in the NHS Cervical Screening Programme: An online experimental study
    Hill, Emily
    Nemec, Martin
    Marlow, Laura
    Sherman, Susan Mary
    Waller, Jo
    [J]. JOURNAL OF MEDICAL SCREENING, 2021, 28 (03) : 333 - 340
  • [14] ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice
    Khan, Michelle J.
    Werner, Claudia L.
    Darragh, Teresa M.
    Guido, Richard S.
    Mathews, Cara
    Moscicki, Anna-Barbara
    Mitchell, Martha M.
    Schiffman, Mark
    Wentzensen, Nicolas
    Massad, L. Stewart
    Mayeaux, E. J., Jr.
    Waxman, Alan G.
    Conageski, Christine
    Einstein, Mark H.
    Huh, Warner K.
    [J]. JOURNAL OF LOWER GENITAL TRACT DISEASE, 2017, 21 (04) : 223 - 229
  • [15] Conservative management of CIN2: National Audit of British Society for Colposcopy and Cervical Pathology members' opinion
    Macdonald, Madeleine
    Smith, John H. F.
    Tidy, John A.
    Palmer, Julia E.
    [J]. JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2018, 38 (03) : 388 - 394
  • [16] MAPK/ERK Signaling Pathway in Hepatocellular Carcinoma
    Moon, Hyuk
    Ro, Simon Weonsang
    [J]. CANCERS, 2021, 13 (12)
  • [17] Original Laser conization for cervical intraepithelial neoplasia: Effectiveness and obstetric outcomes
    Mosseri, Juliette
    Hocquemiller, Raphael
    Mergui, Jean-Luc
    Uzan, Catherine
    Canlorbe, Geoffroy
    [J]. JOURNAL OF GYNECOLOGY OBSTETRICS AND HUMAN REPRODUCTION, 2022, 51 (04)
  • [18] Cervical glandular neoplasia referrals and the diagnosis of adenocarcinoma in situ: Correlating cytology, colposcopy findings, and clinical outcomes
    Nikolopoulos, Manolis
    Athanasias, Pandelis
    Godfrey, Michelle A. L.
    Nikolopoulos, Kostis
    Maheshwari, Manish K.
    [J]. CYTOPATHOLOGY, 2021, 32 (06) : 751 - 757
  • [19] Remission of HPV infection after LEEP-conization - a retrospective study
    Przybylski, Marcin
    Pruski, Dominik
    Millert-Kalinska, Sonja
    Zmaczynski, Andrzej
    Baran, Rafal
    Horbaczewska, Anna
    Jach, Robert
    Zaborowska, Lucja
    [J]. GINEKOLOGIA POLSKA, 2022, 93 (02) : 99 - 104
  • [20] Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
    Sung, Hyuna
    Ferlay, Jacques
    Siegel, Rebecca L.
    Laversanne, Mathieu
    Soerjomataram, Isabelle
    Jemal, Ahmedin
    Bray, Freddie
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 2021, 71 (03) : 209 - 249