Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1449080

Post-conization Pathological Upgrading and Outcomes of 466 Patients with Low-grade Cervical Intraepithelial Neoplasia

Provisionally accepted
Yulin Guo Yulin Guo Hongning Cai Hongning Cai Qiuzi Peng Qiuzi Peng Ying Wang Ying Wang Lu Li Lu Li Miao Zou Miao Zou Jinyue Guo Jinyue Guo Chaonan Wang Chaonan Wang Xufeng Wu Xufeng Wu Quanfu Ma Quanfu Ma *
  • Maternal and Child Health Hospital of Hubei Province, Wuhan, China

The final, formatted version of the article will be published soon.

    The management of patients with low-grade cervical intraepithelial neoplasia (CIN1) remains controversial. We analyzed the pathological upgrading rates of patients with CIN1 undergoing conization, identifying influencing factors, and compared their outcomes to those of patients with CIN1 receiving follow-up only. Methods: This retrospective study included 466 patients with CIN1 confirmed by histopathology and treated with conization. Postoperative pathological upgrading was determined and its influencing factors were identified. We also analyzed post-conization outcomes, examining the rate of persistent/recurrent CIN1 and its influencing factors, and comparing these results to those of patients receiving follow-up only. Results: The pathological upgrading rate of patients with CIN1 after conization was 21.03% (98/466), and the influencing factors were preoperative high-risk human papillomavirus (HR-HPV) infection and cytological results. The upgrading rates of HR-HPV positive and negative patients were 22.05% and 0.00%, respectively (χ 2 =5.03, P=0.03). The upgrading rate of patients with cytological results negative for intraepithelial lesion malignancy was 10.94%, while the upgrading rates of atypical squamous cells, cannot exclude high-grade lesion(ASC-H) and high-grade squamous intraepithelial lesion(HSIL) groups were 47.37% and 52.94%, respectively (χ 2 =22.7, P=0.03). Persistent/recurrent CIN1 rates in the conization group were 21.24%, 15.97%, and 6.67% at 6, 12, and 24 months, respectively, significantly lower than those in the follow-up only group. The CIN2 progression rate in the conization group (0.26%) during the 24-month follow-up period was also significantly lower than that in the follow-up only group (15.15%; χ 2 =51.68, P<0.01). The only factor influencing postoperative persistent/recurrent CIN1 was preoperative HR-HPV status. No patients who were HR-HPV negative preoperatively exhibited persistent/recurrent CIN1, compared with 25.55% of those who were HR-HPV positive preoperatively (χ 2 =4.40, P=0.04). Discussion: The risk of progression to

    Keywords: Cervical Intraepithelial Neoplasia, Conization, cytology, follow-up, Human papillomavirus, pathological upgrading

    Received: 14 Jun 2024; Accepted: 23 Aug 2024.

    Copyright: © 2024 Guo, Cai, Peng, Wang, Li, Zou, Guo, Wang, Wu and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Quanfu Ma, Maternal and Child Health Hospital of Hubei Province, Wuhan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.