4.2 Interpretation
Through Chinese practices for cervical conization14recommended that the indication for surgery for cervical conization was
cervical cytology as HSIL, AIS or cervical cancer, also in clinical
practices, patients underwent conization surgery were mainly HSIL.
However, in this experiment, 2.5% of patients had a pre-diagnosis of
LSIL (Table 1), this was largely because doctors believe that those
patients had the potential to develop the disease, different grades of
lesions at the biopsy site, missed or misdiagnosed HSIL. This was
similar to a Japanese report15 on the pre-diagnosis of
CIN (cervical intraepithelial neoplasia) 1 and 2 in patients with
conization, the report states that approximately half of patients
initially diagnosed with CIN 1 and 2 actually contain CIN3 or invasive
cancer in the cervical tissue. Therefore, it is necessary to combine
actual clinical observations to decide whether to make conization in
patients with LSIL.
About the size of the cone, we found that optimal cone volume and cone
depth can effectively avoid positive margin. Papoutsis et
al.16 reported that in large loop excision of
transformation zone (LLETZ) treatment, cone volume\(<\)2.1cm3 and cone depth \(<\)10mm, or the cone
volume less than 8.6% of initial cervical volume, women were at risk of
having positive margin. Different from cone depth, Kawano et
al.17 suggested that in women younger than 40 years,
optimal cone length of 15mm and 20mm in single-quadrant and
multi-quadrant diseases, respectively.