Görkem AKTAŞ, Belma Gözde ÖZDEMİR, Mete BERTİZLİOĞLU, Mercan ASLAN, Ahmet BİLGİ, Çetin ÇELİK
Journal of Medicine and Palliative Care - 2026;7(3):457-461
Aims: High-grade squamous intraepithelial lesion (HSIL) is among the important precursor lesions of cervical cancer, and progression to invasive cancer can be largely prevented with early diagnosis and appropriate treatment. Excisional procedures, especially loop electrosurgical excision procedure (LEEP), are commonly used to treat HSIL. However, the persistence or recurrence of the lesion after excisional treatment in some patients remains a clinically significant problem. Surgical margin status, human papillomavirus (HPV) infection, and various clinical factors are thought to play a role in the development of persistence. Therefore, identifying the factors that affect persistence after excisional treatment is important for optimizing follow-up and management strategies for patients. The aim of this study is to evaluate demographic, clinical, and pathological factors associated with post-treatment persistence in patients diagnosed with HSIL and treated with conization. Methods: This retrospective study was conducted at a tertiary referral center and included patients diagnosed with HSIL and treated with conization between 2024 and 2025. A total of 69 patients with histopathologically confirmed HSIL were included in the study. Persistence was observed in 46 patients (66.7%), while no persistence was observed in 23 patients (33.3%). Demographic characteristics, clinical findings, and pathological data of the patients were retrospectively reviewed from their patient files. Data collected included age, surgical margin status, length of the removed specimen, and HPV status during follow-up. Patients were divided into two groups based on whether persistence developed during follow-up. Correlation analyses and logistic regression models were used to evaluate factors associated with persistence. Results: No significant differences were found between patients with and without persistence in terms of age, menopausal status, marital status, and smoking (p>0.05). However, positive surgical margins were significantly associated with persistence (p=0.003). In the evaluation of clinicopathological factors, the persistence rate was significantly higher in patients with positive high-risk HPV types (e.g., HPV 16, HPV 31) during follow-up (p=0.002). In logistic regression analysis, positive surgical margins and positive HPV status at follow-up were significant predictors of persistence. Conclusion: Positive surgical margins and HPV positivity during follow-up are significantly associated with persistence after excisional HSIL treatment.
