Department of Obstetrics and Gynecology, University of Campinas, Rua Vital Brasil, 80 Cidade Universitária, Campinas, CEPSão Paulo, 13083-888, Brazil.
Arch Gynecol Obstet. 2022 Sep;306(3):851-856. doi: 10.1007/s00404-022-06464-w. Epub 2022 Feb 27.
To describe the results of 610 patients who underwent LEEP and evaluate factors related to a negative margin.
A retrospective study of patients treated by LEEP at a colposcopy referral service in Campinas, Brazil, 2017-2019. Patients were referred to treat high-grade squamous intraepithelial lesion or adenocarcinoma in situ suspected by cytology and colposcopy (screen-and-treat) or by biopsy. Descriptive analysis was performed by frequencies as a function of the status of the margins (negative or positive). Factors associated with margin status were assessed by regression.
The endocervical, ectocervical or both margins were negative in 82.4%, 75.7% and 65.9%, respectively. Age, sexual debut, parity, menopause status, smoking and hormonal contraception showed no difference in the proportion of negative margins. Both margins were negative in 66.1% of patients with transformation zone type(TZ) 1, 73.1% of TZ 2, and 54.7% of TZ 3 (p = 0.015). The endocervical negative margin was obtained in 78.0% of patients submitted to excision I (loop 10 mm) and 82.5% to excision II (loop 15 mm) (p = 0.016). Having the sexual debut at 18 years or older or being submitted to an excision type II doubled the chance of negative endocervical margin (1.98;1.04-3.77 and 1.95; 1.18-3.21, respectively).
The proportion of negative endocervical margin was 78% in excision I and 86% in excision II. Sexual onset and excision type II increased the chance of obtaining a negative endocervical margin.
描述 610 例接受 LEEP 治疗的患者的结果，并评估与阴性切缘相关的因素。
对巴西坎皮纳斯阴道镜转诊服务中 2017 年至 2019 年接受 LEEP 治疗的患者进行回顾性研究。患者因细胞学和阴道镜检查（筛查-治疗）或活检怀疑有高级别鳞状上皮内病变或原位腺癌而被转诊。通过边缘状态（阴性或阳性）的频率进行描述性分析。通过回归评估与边缘状态相关的因素。
宫颈管内、宫颈外或两者的边缘阴性率分别为 82.4%、75.7%和 65.9%。年龄、初次性行为、产次、绝经状态、吸烟和激素避孕在阴性边缘的比例上没有差异。转化区类型（TZ）1 的患者中，66.1%的双边缘阴性，TZ 2 的患者中 73.1%的双边缘阴性，TZ 3 的患者中 54.7%的双边缘阴性（p=0.015）。接受切除 I（环 10 毫米）的患者中，78.0%的宫颈管内边缘阴性，接受切除 II（环 15 毫米）的患者中 82.5%的宫颈管内边缘阴性（p=0.016）。初次性行为年龄在 18 岁或以上或接受切除 II 型的患者，其宫颈管内阴性边缘的几率增加了一倍（1.98；1.04-3.77 和 1.95；1.18-3.21）。
切除 I 的宫颈管内阴性边缘率为 78%，切除 II 的宫颈管内阴性边缘率为 86%。初次性行为年龄和切除 II 型增加了获得宫颈管内阴性边缘的机会。
