关键词: 病变残存, CIN, 早期浸润癌, 冷刀锥切术

Abstract: Objective To investigate the factors of residual lesions after cold-knife conization(CKC)with cervical intraepithelial neoplasia Ⅲ(CINⅢ),microinvasive carcinoma.Methods 25 cases who had been treated by CKCdue to CINⅢ,microinvasive carcinoma underwent subsequent hysterectomy from October 2001 to December 2007.The pathologic study that carried out on cone-specimens analysis the relationship between endocervical margin status,multiple-quadrant disease,glandular involvement,stroma microinvasive and residual disease in the post-cone hysterectomy specimens.Results 17 out of 25 cases(68%)were diagnosed with no residual lesions after repeated operation.Eight cases(32%)had lesions lower than that of conization.All of five cases with microinvasive carcinoma had degraded residual disease.Three of 20 cases with CINⅢ had degraded residual lesions.No significant difference existed between endocervical margin status,glandular involvement,multiple-quadrant disease and residual disease in the post-cone hysterectomy specimens(P>0.05).Patients with the presence of any two or more of the risk factors mentioned above,especially stroma microinvasive,should be considered as a high-risk group for having disease persistence after conization.Conclusion Patients with microinvasive carcinoma or CIN Ⅲ after conization could be given further individual treatment.

Key words: residual disease, cervical intraepithelial neoplasia, microinvasive carcinoma, cold-knife conization