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Korean Journal of Obstetrics & Gynecology 2007;50(8):1082-1089.
Published online August 1, 2007.
LEEP conization: Risk factors of positive margin.
Kyoung Hoon Zun, Kyoung Chul Jun, Doo Young Chang, Young Ah Kim, Myung Kwon Jeon, Eung Soo Lee
Department of Obstetrics and Gynecology, College of Medicine, Inje University, Ilsan Paik Hospital, Goyang, Gyeonggi, Korea. doogie@ilsanpaik.ac.kr
Conization is the popular procedure to diagnose or treat in most cases of cervical intraepithelial neoplasia (CIN) and some cases of early cervical cancer. Many reports show the conservative management of positive margin is reasonable. Nevertheless, it is generally accepted the positive margin of conization is the major cause of being received additional operation such as hysterectomy. The aim of this study is to evaluate the risk factors of positive margin. PATIENTS AND METHODS: 283 CIN or early cervical cancer women who underwent conization were enrolled this study. We evaluated many possible risk factors for positive margin, including age, weight, height, body mass index (BMI), gravity, parity, abortion, severity of disease, glandular involvement, and human papillomavirus (HPV) infection. RESULTS: Of the 283 patients, 80 (28.2%) had positive margin in their conization specimens. Statistical significant risk factors of positive margin included older age (P(trend) < 0.001), higher BMI (P(trend) = 0.036), more severity of disease (P(trend) < 0.001), and involvement of endocervical gland (OR = 2.5, 95% CI 1.5-4.2). Parity (P(trend) = 0.054) showed statistically marginal significance. Weight (P(trend) = 0.154), height (P(trend) = 0.456), gravity (P(trend) = 0.194), abortion (P(trend) = 0.813), and HPV infection (OR = 1.2, 95% CI 0.5-2.5) were not statistically significant risk factors. CONCLUSIONS: The data of present study demonstrated that older age, high BMI, and higher pathologic diagnosis are statistical risk factors of positive margin we can know preoperatively.
Key Words: Cervical intraepithelial neoplasia (CIN), Conization, Resection margin, Risk factor
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