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571 Prognostic factors for HSIL resection margin involvement after LLETZ procedure
  1. Yavor Dimitrov Kornovski1,
  2. Yonka Ivanova Ivanova1,
  3. Stoyan Georgiev Kostov1,2,
  4. Stanislav Hristov Slavchev1,
  5. Dimitar Metodiev Mitkov3,4 and
  6. Angel Danchev Yordanov5
  1. 1Department of Gynecology, Hospital ‘Saint Anna’, Medical University—’Prof. Dr. Paraskev Stoyanov’, 9002 Varna, Bulgaria, Varna, Bulgaria
  2. 2Research Institute, Medical University Pleven, 5800 Pleven, Bulgaria, Pleven, Bulgaria
  3. 3Clinical Pathology Laboratory, MHAT ‘Nadezda’ Women’s Health Hospital, 1373 Sofia, Bulgaria, Sofia, Bulgaria
  4. 4Neuropathological Laboratory, University Hospital ‘Saint Ivan Rilski’, 1431 Sofia, Bulgaria, Sofia, Bulgaria
  5. 5Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria, Pleven, Bulgaria


Introduction/Background The high-grade squamous intraepithelial lesion (HSIL) is a well-defined precursor lesion of the invasive squamous cervical cancer(CC). It is more frequent than the invasive CC itself. It is easy to prevent CC by early detection and appropriate treatment of HSIL.

The aim of this study was to investigate the impact of the following prognostic factors: age, parity, hormonal status (premenopausal, postmenopausal), histological result of targeted biopsy (low-grade squamous intraepithelial lesion(LSIL), HSIL), adequacy of colposcopic examination, transformation zone (TZ) type, type of cervical lesion (type 1, 2, 3), colposcopic diagnosis/impression (LSIL/grade1, HSIL/grade 2), lesion size (up to 1/3; up to 2/3; over 2/3 of cervical circumference) for the HSIL resection line involvement after loop electrosurgical excision (LLETZ) procedure.

Methodology Prospective study (01.01.2017 - 31.07.2021) including 189 patients with cervical precancerous lesions treated by the LLETZ. One gynecologic oncologist performed video colposcopy with Leisegang colposcope with original software and monitor, targeted biopsy, and LLETZ. One histopathologist diagnosed histological specimens from the biopsy and LLETZ procedure. The LLETZ procedure was performed with different-sized loops and a SURTRON device with cutting and coagulation modes, and cutting and coagulation of 100 and 60 W powers, respectively.

The data were entered and processed with the IBM SPSS Statistics 25.0 statistical package and MedCalc Version 19.6.3. The significance level at which the null hypothesis was rejected was set at p<0.05.

Results 7 HSIL patients (3.7%) had cone resection margin involvement after LLETZ. In the analysis of the above factors, we found a significant difference (p<0.05) only for the factor of histological diagnosis from targeted biopsy for the HGSIL resection margin involvement after LLETZ procedure.

Conclusion The HSIL histological score of targeted biopsy is the only significant prognostic factor for resection margin involvement after LLETZ procedure.

Disclosures Authors certify they have nothing to disclose.

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