ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1645322
This article is part of the Research TopicCutting-Edge Strategies in Screening, Prevention, and Treatment in Gynaecologic OncologyView all 16 articles
Residual/Recurrent Lesions after cold-knife conization for High-Grade Cervical Intraepithelial Neoplasia: Risk Factor Analysis and Clinical Management Recommendations
Provisionally accepted
- 1The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
- 2Air Force Medical University, Xi'an, China
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Objective: This study aimes to evaluate the risk factors of residual/recurrent lesions of cervical intraepithelial neoplasia 2/3 (CIN2/3) in patients who underwent cold-knife conization (CKC).Methods: A total of 976 patients with CIN2/3 who were treated with CKC were retrospectively analyzed. Post-CKC follow-up involved a thin-prep cytology test (TCT) and human papillomavirus (HPV) tests. Residual/recurrent lesions after CKC (RLC) were defined as biopsy-proven CIN2/3 during follow-up, whereas residual lesions identified after a hysterectomy (RLH) were defined as lesions in patients who underwent a hysterectomy 1-6 months after CKC and were diagnosed with CIN 2/3, cervical carcinoma in situ or invasive cancer. Univariate analysis and multivariate logistic regression analyses were performed to evaluate the relationship among factors such as age, menopausal status, pregnancy, parity, transformation zone, the height of excision, glandular involvement, persistent HPV infection, HPV infection types (preoperative and postoperative), TCT test (preoperative and postoperative), postoperative margins, Elongating the clinical follow-up period is of paramount importance, particularly for patients with high-risk factors; therefore, it is recommended that follow-up intervals be reduced. For patients with HPV16/18 infection, positive margins, and positive ECC, it is recommended that a hysterectomy be performed whenever necessary.
Keywords: Cold knife conization, High-grade squamous intraepithelial lesion, Human papillomavirus, Hysterectomy, postoperative residual/recurrent, Risk factors
Received: 11 Jun 2025; Accepted: 07 Aug 2025.
Copyright: © 2025 Wu, Guo, Huang, Guo and Xiong. 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: Lili Xiong, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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