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.