Gül Aydın Şule, Baş Sevda, Özmen Fatma, Yaşar Şeyma, Taş Zeynel Abidin, Nessar Ahmet Zeki, Seyfettinoğlu Sevtap, Narin Mehmet Ali
Department of Obstetrics and Gynecology, Adana City Training and Research Hospital, Adana 01230, Turkey.
Department of Gynecologic Oncology, Adana City Training and Research Hospital, Adana 01230, Turkey.
J Clin Med. 2025 Aug 21;14(16):5918. doi: 10.3390/jcm14165918.
The aim of this study was to evaluate the cervical regeneration process following monopolar electrosurgical conization (MESC), using a multimodal approach including ultrasonographic, cytologic, colposcopic, and histologic assessments, and to determine the relationship between the extent of excision and the capacity for cervical tissue regeneration. This prospective observational study included 28 patients who underwent MESC due to abnormal cervical cytology or biopsy-confirmed cervical intraepithelial neoplasia. Preoperative, postoperative one month and six month cervical measurements were obtained using two-dimensional transvaginal ultrasonography. Monthly colposcopic evaluations were conducted, cervical biopsies were taken at the third month, and a cytological assessment was performed at the sixth month. Cervical volume and length regeneration were calculated and analyzed in relation to the dimensions of the excised cone. Regeneration percentages and their correlations with excised tissue dimensions were evaluated using paired -tests and Pearson correlation analysis. Mean cervical volume and length regeneration rates at six months were 84.61% ± 5.64 and 86.36% ± 3.33, respectively. The transformation zone was histologically visible in 32.1% of patients at three months and cytologically in 75.9% at six months. An inverse correlation was observed between both cone volume and length and cervical regeneration ( < 0.005). Patients with larger preoperative cervical dimensions exhibited a higher regenerative capacity. Positive surgical margins were found in only one patient (3.4%), and no high-grade cytologic abnormalities were noted at follow-up. MESC may enable substantial cervical regeneration within six months. Larger excisions impair healing and delay transformation zone reformation, which may inform the optimal timing for initiating gynecological and colposcopic examinations, as well as for performing cervical interventions when indicated.
本研究的目的是采用包括超声、细胞学、阴道镜和组织学评估在内的多模式方法，评估单极电外科锥形切除术（MESC）后的宫颈再生过程，并确定切除范围与宫颈组织再生能力之间的关系。这项前瞻性观察性研究纳入了28例因宫颈细胞学异常或活检证实为宫颈上皮内瘤变而接受MESC的患者。术前、术后1个月和6个月使用二维经阴道超声测量宫颈。每月进行阴道镜评估，在第3个月进行宫颈活检，并在第6个月进行细胞学评估。计算并分析宫颈体积和长度的再生情况与切除锥形组织尺寸的关系。使用配对t检验和Pearson相关分析评估再生百分比及其与切除组织尺寸的相关性。6个月时宫颈体积和长度的平均再生率分别为84.61%±5.64和86.36%±3.33。3个月时，32.1%的患者组织学上可见转化区，6个月时75.9%的患者细胞学上可见转化区。观察到锥形组织的体积和长度与宫颈再生之间呈负相关（P<0.005）。术前宫颈尺寸较大的患者表现出较高的再生能力。仅1例患者（3.4%）发现手术切缘阳性，随访期间未发现高级别细胞学异常。MESC可能在6个月内实现宫颈的大量再生。较大的切除会损害愈合并延迟转化区的重新形成，这可能为启动妇科和阴道镜检查以及在有指征时进行宫颈干预的最佳时机提供参考。
