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Abstract To explore the risk factors of the residual or positive lesions in resection margin after cervical cold knife conization (CKC) for treating the high-grade squamous intraepithelial lesion (HSIL) of cervix. Methods: The clinical data of 110 patients who underwent CKC for treating their HSIL of cervix from January 2017 to January 2019 were analyzed retrospectively. These patients were divided into group A (29 patients with supplementary surgery) and group B (81 patients without supplementary surgery) according to whether they were given supplementary surgery caused by residual or positive lesions in resection margin. The related factors of supplementary surgery after CKC were explored. Results: There were significant different in the proportions of parity >2 times (58.7% vs. 65.5%) and irregular menstruation (35.8% vs.43.2%) of the patients between the two groups. The proportions of the high risk HPV infection >2 types, the lesions of pathological classification with CIN III, the lesions of cervical transformation zone with CIN III, the lesions involved in glands, the lesions involved over 2 quadrants of cervix, and the cervical contact bleeding of the patients in group A were 55.2%, 69.0%, 62.1%, 58.6%, 51.7%, and 62.1%, respectively, which were significantly different from those (29.6%, 45.7%, 32.1%, 37.0%, 29.6%, 40.7%, respectively) of the patients in group B (P<0.05). There were no significant differences in the proportions of HPV infection and the ectopic degree of cervical cylindrical epithelium of the patients between the two groups (P>0.05). The proportions of the primary cervical conical incision width ≤15mm and primary conical incision volume by CKC ≤2cm3 of the patients in group A were significantly higher than those of the patients in group B, but the primary cervical resection depth of the patients in group A was significantly less than that of the patients in group B (P<0.05). Logistic multifactor regression analysis showed that high-risk HPV infection >2 types, the lesions of cervical transformation zone with CIN III, the lesions involved in glands, the lesions involved more than two quadrants of cervix, the cervical contact bleeding, the primary cervical conical incision width ≤15mm, primary conical incision volume by CKC ≤2cm3, and the cervical resection depth of the patients were the independent risk factors of supplementary surgery caused by residual or positive lesions in resection margin after CKC (P<0.05). Conclusion: The risk factors of supplementary surgery caused by residual or positive lesions in cervical resection margin after CKC should be paid enough attention to in clinic.
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