Transformation Zone-Guided Cervical Conization: Defining Optimal Parameters to Minimize Residual Disease

Transformation Zone-Guided Cervical Conization: Defining Optimal Parameters to Minimize Residual Disease | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Transformation Zone-Guided Cervical Conization: Defining Optimal Parameters to Minimize Residual Disease Wang Mingyu, Qu Pengpeng This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6412083/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective To determine the optimal cone length and excision conization angle for preventing residual lesions and reducing recurrence in patients with high-grade squamous intraepithelial lesions (HSILs) via cervical conization. Methods We analyzed the data of 209 patients who underwent cold knife conization (CKC) before December 2020, categorized by transformation zone (TZ) type. Critical values for cone length and the ratio of cone length to cone thickness were identified and validated prospectively in 164 patients after January 2021. Sensitivity, specificity, and diagnostic efficacy were assessed via receiver operating characteristic (ROC) curves. Results The critical values for type I-II TZs were 1.60 cm and 1.40, with an AUC of 0.83, whereas those for type III TZs were 1.97 cm and 2.17, with an AUC of 0.96. Conclusion Tailoring the cone length and excision conization angle to the TZ type effectively minimizes tissue removal while preventing residual lesions and reducing the risk of recurrence. Cervical intraepithelial neoplasia Conization Transformation zone Residual lesions Surgical margins Fertility preservation Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 28 May, 2025 Reviewers agreed at journal 26 May, 2025 Reviewers invited by journal 21 May, 2025 Editor invited by journal 25 Apr, 2025 Editor assigned by journal 24 Apr, 2025 Submission checks completed at journal 24 Apr, 2025 First submitted to journal 09 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6412083","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":459980055,"identity":"db036a2c-6607-464a-a0e4-2392e347456b","order_by":0,"name":"Wang Mingyu","email":"","orcid":"","institution":"Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin Medical University，Tianjin","correspondingAuthor":false,"prefix":"","firstName":"Wang","middleName":"","lastName":"Mingyu","suffix":""},{"id":459980056,"identity":"9c3509cf-34bd-4b4c-8959-09bbbea03e05","order_by":1,"name":"Qu Pengpeng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYJADxsdgipm5gWgtzMYMDAZAipF4LWzSYC0MBLTw3Uhge/BxR20ev3T7teqCij/R/O1ALT8qtuHUInkjgd1w5pnjxZJzzpTdnnHGIHfGYcYGxp4zt3FqMQDaIs3bdixxw42ctNu8bQa5DUAtzIxtBLT8BWrZD9RSDNIynygtjG01iRsk0o8xg7RsIKRF8szDdsPetgPFEjdymKV5zhjnbgRqOYjPL3zHk489+NlWl8c/I/3hZ54Kudx55w8ffPCjArcWhgOMbUDycAIDA48BQhC3erAsG5CsA2phf4BX4SgYBaNgFIxcAACORl4cXTXwUAAAAABJRU5ErkJggg==","orcid":"","institution":"Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin Medical University，Tianjin","correspondingAuthor":true,"prefix":"","firstName":"Qu","middleName":"","lastName":"Pengpeng","suffix":""}],"badges":[],"createdAt":"2025-04-09 12:53:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6412083/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6412083/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83354000,"identity":"88e530f5-7c89-4557-a301-19feaedbae95","added_by":"auto","created_at":"2025-05-23 14:38:37","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":428338,"visible":true,"origin":"","legend":"","description":"","filename":"TransformationZoneBasedConizationOptimizingConeDimensionstoReduceResidualLesions7.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6412083/v1_covered_fc38df7c-4bc5-4845-9d7f-95a2267e5ec3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Transformation Zone-Guided Cervical Conization: Defining Optimal Parameters to Minimize Residual Disease","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cervical intraepithelial neoplasia, Conization, Transformation zone, Residual lesions, Surgical margins, Fertility preservation","lastPublishedDoi":"10.21203/rs.3.rs-6412083/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6412083/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo determine the optimal cone length and excision conization angle for preventing residual lesions and reducing recurrence in patients with high-grade squamous intraepithelial lesions (HSILs) via cervical conization.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe analyzed the data of 209 patients who underwent cold knife conization (CKC) before December 2020, categorized by transformation zone (TZ) type. Critical values for cone length and the ratio of cone length to cone thickness were identified and validated prospectively in 164 patients after January 2021. Sensitivity, specificity, and diagnostic efficacy were assessed via receiver operating characteristic (ROC) curves.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe critical values for type I-II TZs were 1.60 cm and 1.40, with an AUC of 0.83, whereas those for type III TZs were 1.97 cm and 2.17, with an AUC of 0.96.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eTailoring the cone length and excision conization angle to the TZ type effectively minimizes tissue removal while preventing residual lesions and reducing the risk of recurrence.\u003c/p\u003e","manuscriptTitle":"Transformation Zone-Guided Cervical Conization: Defining Optimal Parameters to Minimize Residual Disease","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-23 14:14:23","doi":"10.21203/rs.3.rs-6412083/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-05-28T04:45:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92301051635529176551193554215200371668","date":"2025-05-27T00:54:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-21T15:03:47+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-25T11:26:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-24T23:34:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-24T23:31:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Women's Health","date":"2025-04-09T12:50:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4cca9aa9-82a2-4dfb-af47-8f05769d3075","owner":[],"postedDate":"May 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-23T14:14:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-23 14:14:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6412083","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6412083","identity":"rs-6412083","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}