Korean J Obstet Gynecol.  2007 Aug;50(8):1082-1089.

LEEP conization: Risk factors of positive margin

• Zun KH
• Jun KC
• Chang DY
• Kim YA
• Jeon MK
• Lee ES

Abstract

OBJECTIVE
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.

Keyword

Cervical intraepithelial neoplasia (CIN); Conization; Resection margin; Risk factor

MeSH Terms

Body Height
Cervical Intraepithelial Neoplasia
Conization*
Diagnosis
Female
Gravitation
Humans
Hysterectomy
Parity
Risk Factors*
Uterine Cervical Neoplasms