Mitta K, Tsertanidou A, Tsakiridis I, Zoubanioti E, Dagklis T, Mamopoulos A, Athanasiadis A, Kalogiannidis I
Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
Hippokratia. 2023 Oct-Dec;27(4):132-140.
This study aimed to identify the risk factors of recurrence following surgical excisional procedures for cervical intraepithelial lesions (CIN).
We conducted a retrospective cohort study of women with cervical pathology treated surgically over seven years. All patients with surgical interventions of the cervix were recorded and analyzed according to the recurrence following their primary treatment. We utilized the Chi-square test and the multivariate regression analysis to identify recurrence risk factors. We also employed the Kaplan-Meier survival analysis for disease recurrence.
In total, 83 patients were reported; 81 (97.6 %) were treated with loop electrosurgical excision, and two (2.4 %) with cold knife conization. The histopathological results of the treatment approach showed one case (1.2 %) of low-grade intraepithelial lesions, 70 (84.4 %) high-grade intraepithelial lesions (HSIL), five (6 %) with IA1, and two (2.4 %) with IA2, cervical cancer, while in five patients (6 %) the results were negative for cervical pathology. Recurrence was diagnosed in 23 cases (27.7 %), and HSIL was diagnosed in 10 patients (12 %). The median time of recurrence was 11.6 months. Positive endocervical margins [odds ratio (OR): 52.478; 95 % confidence interval (CI): 8.315-331.203; p <0.001], excision of the cone in multiple specimens (OR: 8.793; 95 % CI: 1.854-41.693; p =0.006), and depth of cone less than one cm (OR: 21.225; 95 % CI: 3.176-141.863; p =0.002) were identified as independent risk factors for recurrence.
Positive endocervical margins, multiple loop passes, and depth of the cone less than one cm were the most significant risk factors for recurrence. HIPPOKRATIA 2023, 27 (4):132-140.
本研究旨在确定宫颈上皮内瘤变（CIN）手术切除术后复发的危险因素。
我们对7年间接受手术治疗的宫颈病变女性进行了一项回顾性队列研究。记录并分析所有接受宫颈手术干预的患者初次治疗后的复发情况。我们采用卡方检验和多因素回归分析来确定复发危险因素。我们还采用Kaplan-Meier生存分析评估疾病复发情况。
共报告83例患者；81例（97.6%）接受了环形电切术，2例（2.4%）接受了冷刀锥切术。治疗方法的组织病理学结果显示，1例（1.2%）为低级别上皮内瘤变，70例（84.4%）为高级别上皮内瘤变（HSIL），5例（6%）为IA1期，2例（2.4%）为IA2期宫颈癌，5例患者（6%）宫颈病理结果为阴性。23例（27.7%）诊断为复发，10例患者（12%）诊断为HSIL。复发的中位时间为11.6个月。宫颈切缘阳性[比值比（OR）：52.478；95%置信区间（CI）：8.315 - 331.203；p <0.001]、多个标本进行锥切（OR：8.793；95% CI：1.854 - 41.693；p =0.006）以及锥切深度小于1厘米（OR：21.225；95% CI：3.176 - 141.863；p =0.002）被确定为复发的独立危险因素。
宫颈切缘阳性、多次环形电切以及锥切深度小于1厘米是复发的最显著危险因素。《希波克拉底》2023年，27（4）：132 - 140。
