Objective:To establish a risk model of placenta accreta spectrum(PAS) based on the clinical risk factors and ultrasound signs of patients with placenta accreta, and identify severe placenta accreta prenatal.Methods:A retrospective analysis was performed on 121 PAS patients admitted to Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2018 to June 2022 who were clinically classified or pathologically diagnosed during delivery. The two groups were divided into light and severe groups according to the implantation type. The clinical risk factors and ultrasound signs between the two groups were compared. A risk model of PAS was established based on the clinical risk factors and ultrasound signs to predict the perinatal complications.Results:A total of 130 cases of PAS were clinically diagnosed or pathologically diagnosed with placenta, 9 cases with incomplete clinical data or irregular ultrasound images were excluded, and the remaining 121 cases were included in the study. Among the 121 patients, 64 cases were placental accreta, 39 cases were placental increta, and 18 cases were placenta percreta. The placental accreta was defined as mild group, and the combination of placental increta and placenta percreta were referred to as severe group. There were no significant differences in placenta previa, and the number of uterine cavity operations (all P>0.05). There were significant differences in the number of cesarean section, myometrium thinning, placental lacunae, abnormal vascularization at the utero-bladder junction, bridging vessels at the utero-bladder junction, placental protuberance and cervical involvement (all P<0.05). Binary logistic regression analysis showed that placental lacunae, abnormal vasculization of the utero-bladder interface and the number of cesarean sections were independent risk factors for severe PAS. Based on this, a risk model was established and the ROC curve of each independent risk factor and risk model was plotted respectively. The AUC of the risk model was 0.826, which had better diagnostic efficacy than other independent risk factors. Conclusions:In the prenatal ultrasound classification diagnosis of high-risk patients with PAS, the placental lacunae, abnormal vascularization of utero-bladder interface and the number of cesarean section are combined to establish the risk model of PAS, which has a good diagnostic efficacy for severe placenta accreta.

目的 探讨产前超声征象及高危因素在不伴前置胎盘的胎盘植入性疾病(PAS)诊断中的临床应用价值.方法 回顾性分析于我院规范产检并经临床或病理诊断的8例不伴前置胎盘的PAS患者资料,对其产前典型超声征象、高危因素及妊娠结局进行总结分析.结果 8例不伴前置胎盘的PAS患者中,6例有剖宫产史(其中5例有宫腔操作史),2例无剖宫产史(均有宫腔操作史);6例产前超声提示胎盘植入,2例产前超声漏诊;胎盘粘连3例,胎盘植入4例,胎盘穿透1例;7例发生产后大出血(出血量≥1000 ml),1例产后出血量800 ml;1例行子宫全切术,7例保留子宫.6例产前超声发现胎盘植入的典型征象,均存在子宫-膀胱交界面异常,主要表现为子宫肌层变薄、胎盘后方低回声带消失,其中3例存在胎盘陷窝及子宫-膀胱交界面桥接血管;2例产前超声未检出胎盘植入典型征象.结论 产检过程中将高危因素的筛查与PAS产前超声筛查规范相结合,应用二维灰阶超声和彩色多普勒超声全面扫查胎盘对不伴前置胎盘的PAS的诊断具有重要的临床价值.

目的 分析妊娠合并宫颈鳞状细胞癌的临床特点、病理特征、诊疗方法及预后,为肿瘤的诊断及治疗提供更多的临床经验.方法 回顾性分析2011年1月至2020年12月首都医科大学附属北京妇产医院收治的10例妊娠合并宫颈鳞状细胞癌患者的临床资料.结果 患者平均年龄为35.5岁(30～42岁),其中早孕期2例、中孕期4例、晚孕期4例.根据国际妇产科联盟2018宫颈癌分期标准:ⅠA期1例(10％),ⅠB期3例(30％),Ⅱ期及以上6例(60％).7例患者主要的临床表现为阴道出血,4例患者均先进行了不同程度的保胎措施,导致诊断延后.早孕及中孕的6例患者中有4例选择继续妊娠至晚孕期终止妊娠.1例早孕期诊断为IA1期患者于孕15周行宫颈冷刀锥切术及宫颈环扎术后,于孕39周经阴道分娩;3例中孕期诊断为IB3及ⅡA2期的患者,均行新辅助化疗延长孕周后行剖宫产终止妊娠,并行宫颈癌标准治疗.晚孕期确诊患者4例,均于确诊后1～3周内终止妊娠,1例IB2期患者在行剖宫产术的同时行宫颈癌手术治疗,另外2例ⅡB期及1例ⅢB期患者,均于剖宫产术后行同步放化疗.随访期间1例ⅢB期患者未完成治疗,放弃治疗后随访13个月死亡.另外9例患者均无瘤存活.结论 妊娠合并宫颈鳞状细胞癌患者缺乏特异临床表现,诊断时常为中晚期.重视孕期宫颈癌筛查,提高对妊娠合并宫颈癌的警惕性,做到早诊断早治疗.IA1期无高危因素患者可选择宫颈冷刀锥切术治疗,孕期及产后严密随诊.孕中晚期患者需结合患者生育愿望,可考虑行新辅助化疗延长孕周后适时行剖宫产终止妊娠,结合肿瘤分期根据宫颈癌治疗指南进行治疗.

宫颈癌的发病率及死亡率在女性恶性肿瘤中均位居第4,约占女性恶性肿瘤的6.5％,在2020年,全世界共有604127例新发病例及341831例死亡病例 [1]. 绝大部分宫颈癌由高危型人乳头瘤病毒(human papillomavirus,HPV)的持续感染所致,被称为HPV相关性宫颈癌.70％～75％宫颈癌及40％～60％癌前病变与HPV16型及18型感染相关.随着全球HPV疫苗接种率增高带来的保护性,以及HPV检测作为初筛技术的发展,很多早期病变得到筛查和处理,HPV相关性宫颈癌的死亡率逐渐降低.但近5％宫颈癌的发生与HPV感染无关,主要为一些少见的病理类型,根据第5版世界卫生组织(World Health Organization, WHO)女性生殖肿瘤分类,称之为HPV非依赖性宫颈癌 [2-3].随着宫颈癌研究的不断深入,目前对HPV非依赖型宫颈癌的研究越来越受到重视.HPV非依赖性宫颈癌常常发现时分期更晚,预后更差.因此了解HPV非依赖性宫颈癌的临床特点、病理及分子特征进展,可以为宫颈癌的治疗及改善预后提供新的思路.

目的 探讨胰岛素样生长因子2 mRNA结合蛋白3(insulin like growth factor 2 mRNA binding protein 3,IMP3)在卵巢高级别浆液性癌(high grade serous carcinoma,HGSC)及子宫浆液性癌(uterus serous carcinoma,USC)中的表达及意义.方法 选取2017年1月至2020年12月经首都医科大学附属北京妇产医院病理科明确诊断的卵巢HGSC及USC患者各43例,收集患者临床资料并观察组织学特点,采用免疫组化染色检测癌组织中IMP3、ER、PR、p53、p16、WT1等的表达情况,分析免疫表达与临床病理特征的相关性以及IMP3对两种浆液性癌起源部位的鉴别意义及预后评估价值.结果 卵巢HGSC及USC组患者具有相似的浆液性癌的组织病理学特点,但在发病年龄、网膜/腹膜是否累及、腹腔冲洗液/腹水细胞学检查阳性、国际妇产科联盟(The International Federation of Gynecology and Obstetrics,FIGO)分期以及IMP3、ER、PR、p16、WT1抗体表达方面差异均有显著性(P<0.05),而在淋巴结转移及p53表达方面差异无显著性(P>0.05).与卵巢HGSC组相比,USC组患者发病年龄更大但分期较早,不易累及网膜/腹膜和出现腹腔冲洗液/腹水细胞学检查阳性,IMP3、p16阳性率更高,而ER、PR及WT1阳性率更低,差异均有显著性(P<0.05).IMP3表达与两组发病年龄、淋巴结转移、累及网膜/腹膜、腹腔冲洗液/腹水细胞学检查阳性、FIGO分期等临床病理参数以及ER、PR、p53、p16、WT1抗体表达均无关(P>0.05).结论 IMP3表达对鉴别浆液性癌的起源部位具有一定诊断价值,对卵巢HGSC及USC的预后价值尚不明确.

Objective:To explore the the predictive value of ultrasound signs of the involvement of the cervix in the clinical grade diagnosis of placenta accreta spectrum(PAS) with placenta previa and adverse pregnancy outcomes.Methods:A retrospective analysis was performed on PAS patients with placenta previa diagnosed during delivery or by cesarean section in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2018 to March 2021. According to the signs of cervical involvement on prenatal ultrasound, the patients were divided into cervical involvement group and cervical non-involvement group. Logistic analysis was performed on clinical data between the two groups. The clinical data, hysterectomy rate, intraoperative blood loss and clinical diagnosis were compared between the two groups.Results:There were 1 455 patients with PAS diagnosed by clinical diagnosis or placental pathology, of which 170 were with placenta previa, 24 with incomplete clinical data or non-standard ultrasound images, and the remaining 146 patients were included. In the cervical involvement group, all of 6 cases had placenta percreta. Of the 140 cases in the unaffected cervical group, 89 cases (63.6%) had placental accreta, 48 cases (34.3%) had placental increta, and 3 cases (2.1%) had placenta percreta. There were no significant differences of the age and uterine operation history between the two groups. There was significant difference in the number of cesarean sections between the two groups ( P<0.05). There were significant differences in intraoperative blood loss, hysterectomy rate and placenta accreta grade diagnosis between the two groups(χ 2/ Z=4.203, 11.165, 95.248, all P<0.05). Conclusions:The ultrasonographic signs of cervical involvement have a good predictive value for the pregnancy outcome of PAS.

住院医师规范化培训第二阶段考试是医师考核的必经之路,专科医院病理科住院医师在规范化培训第二阶段考试中因专业方向所限存在病理标本种类局限、知识面狭窄等问题,另外全国住院医师第一阶段规范化培养方式及考核标准不一,导致部分住院医师能力参差不齐.本文结合首都医科大学附属北京妇产医院病理科的培训经验提出利用现有的学习条件从严格教学管理制度、多种途径进行病理教学与实践等方面制订有效的解决方案,并提出了一种可在未来病理科住院医师培训中应用的新型培养模式,旨在更好地解决专科医院病理科住院医师规范化培训第二阶段考试面临的问题.

目的 探讨宫颈腺样基底细胞癌(adenoid basal carcinoma,ABC)的临床特征.方法 回顾性分析2013年1月至2019年12月首都医科大学附属北京妇产医院收治的8例ABC患者的临床资料和组织病理学特征,并复习相关文献.结果 患者均为绝经后女性,多无明显临床症状,为体检时发现.7例HPV阳性.2例合并宫颈浸润性鳞状细胞癌行宫颈癌根治术,其中1例术后补充同步放化疗;6例合并高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL),行全子宫+双附件切除术.病理明确ABC的诊断.术后随访未见复发及转移.结论 宫颈ABC发生率低,好发于绝经后老年女性,缺乏特异性临床表现,常伴有高危型人乳头瘤病毒(human papilloma virus,HPV)感染及宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN),该肿瘤生物学行为惰性,整体预后较好.

Objective: To investigate the clinicopathological characteristics and diagnosis of ovarian Brenner tumors. Methods: Forty-seven cases of ovarian Brenner tumors were enrolled from January 2012 to May 2018 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Clinical data, imaging examination, histopathological characteristics and immunohistochemical phenotype were analyzed. Results: The age of the patients ranged from 30-73 years and the mean age was 55 years. Thirty-nine patients (83.0%) were postmenopausal. Forty cases (85.1%) of the Brenner tumors were benign, five (10.6%) borderline and two (4.3%) malignant. Usual tumor markers of ovarian carcinoma, including CA199 and CA125 were normal or mild elevated in the 47 cases. Imaging before surgery was not specific to Brenner tumors. Microscopically, benign Brenner tumors were composed of nests of bland, transitional-type cells within a fibromatous stroma. In our 5 cases of borderline Brenner tumors, mildly atypical transitional-type cells were projected into the cyst lumens and lack of stromal invasion. In 2 cases of malignant Brenner tumors, different degrees of nuclear atypial transitional-type cells exhibited stromal invasion. Immunohistochemical stains for CK7, GATA3, p63 and CK5/6 were positive in all cases. Ki-67 was less than 5% in Brenner tumors, and up to 20%-30% in malignant Brenner tumors. Conclusion: Brenner tumors are mostly seen in postmenopausal patients and are usually benign. Imaging examination and usual ovarian tumor markers do not provide diagnostic value. Diagnosis and classification of Brenner tumors depend on histopathological evaluation.

卵巢透明细胞癌与其他组织类型卵巢上皮性癌不同,具有特异的形态学及免疫表型以及特异的分子生物学改变,与子宫内膜异位症相关,流行病学具有种族倾向性.近年来,其临床病理特征及分子生物学研究有了一定的进展,本文从这两个方面为主线,综述卵巢透明细胞癌的诊治研究进展.

输卵管日益受到重视,与输卵管肿瘤性病变相比,输卵管炎症性病变相对更为常见.输卵管在生殖过程中有着重要生理功能,输卵管感染引起的炎症性疾病也是一个日益严重的问题,熟悉输卵管炎症性病变的诊断和鉴别诊断是非常必要的,从而提高输卵管炎症的诊治正确性,并为不孕症患者提供帮助.输卵管炎症性病变主要包括感染性输卵管炎以及其他伴有炎细胞浸润的非肿瘤性病变.

目的 探讨子宫颈小细胞癌的临床病理特点及诊治要点.方法 收集2016年8月—2018年7月首都医科大学附属北京妇产医院诊治的5例子宫颈小细胞癌患者的临床病理资料及随访资料,回顾性分析其临床病理特点、治疗效果及预后.结果(1)临床特点:5例子宫颈小细胞癌患者的发病年龄为29～57岁,中位发病年龄34岁;临床表现无特异性,主要为接触性出血(2例)或阴道不规则流血(1例)、阴道排液(1例);临床分期:Ⅰb1期1例、Ⅰb2期1例、Ⅱa2期2例、Ⅲc期1例.(2)病理特点:术前活检的误诊率为2/5.小细胞癌的镜下观,形态较为一致的小细胞呈弥漫、成片、巢团样排列,细胞质较少,细胞核深染,核分裂象及坏死多见;3例患者淋巴脉管间隙浸润阳性.免疫组化法检测显示,突触素(Syn)、嗜铬素A(CgA)、CD56、p16、细胞角蛋白(CK)均呈阳性表达,阳性表达率均为5/5.(3)治疗:5例患者均行子宫全切除+双侧附件或双侧输卵管(分别为2、3例)切除+盆腹腔淋巴清扫术,术后均行辅助化疗和(或)放疗,其中3例患者行新辅助化疗.(4)预后:末次随访日期为2018年8月,随访期内3例患者无瘤生存,2例患者确诊后半年多(分别为7、8个月)出现远处转移.结论 子宫颈小细胞癌的术前活检诊断较困难,容易误诊,最终确诊依据镜下形态学观察及免疫组化法检测;治疗方案采用手术联合放化疗的综合治疗,患者的预后较差,易发生远处转移.

林奇综合征(lynch syndrome,IS),既往称为遗传性非息肉病性结直肠癌(hereditary nonpolyposis colorectal cancer,HNPCC),是一种常染色体显性遗传病,由DNA错配修复(mismatch repair,MMR)基因MLH1、MSH2、MSH6或(和)PMS2的胚系突变导致微卫星不稳定性(microsatellite instability,MSI)而引起.其家族易感者一生中均具有发展成癌的危险性,主要表现为结直肠癌、子宫内膜癌及其它的癌,包括小肠癌、胃癌、胆管癌、卵巢癌、肾盂/输尿管癌、皮脂腺肿瘤等.LS患者约占所有子宫内膜癌(endometrial cancer,EC)患者的2％～3％,EC是LS患者肠外最常见的肿瘤,约50％的LS女性患者临床首发症状表现为EC[1],因此LS相关性EC(LS-EC)逐渐成为医学界关注的焦点之一.确诊EC与IS相关对LS患者及其家属的早期诊断、筛查和预防等均有重大意义.近年来,欧美等发达国家对于LS-EC的研究取得了长足进展,但国内相应的研究仍处在起步阶段,并未得到相应的重视.本文将就LS-EC的相关分子机制、检测方法、临床病理意义等方面的研究进展进行综述.

Purpose To explore the clinicopathological features, diagnosis, differential diagnosis and prognosis of placental mesenchymal dysplasia. Method The clinicopathological data of 5 cases with placental mesenchymal dysplasia were retrospectively analysed and related literatures were also re-viewed. Results All of 5 patients were consciously fetal movement disappeared or found abnormal ultrasound results at routine examination of the pregnancy. The placentas were enlarged, partly with oedematous "grape-like" cysts. On histologic exami-nation, enlarged villi with varying degrees of edema contained abnormal thick walled fetal blood vessels. The chorionic vessels were expanded and congested, and some chorionic villi showed mesenchymal cell hyperplasia. In immunohistochemical staining, p57 was positive, and Ki-67 showed low expression. There was no the trophoblastic proliferation. It's mainly differential diagnosis was hydatidiform mole.2 cases were accompanied with stillbirth. Conclusion The diagnosis of placental mesenchymal dysplasia can be confirmed by pathology examination. When a cystic placenta is detected by ultrasound examination, placental mesenchymal dysplasia should be considered in the differential diagnosis.

Objective: To investigate the frequency of KRAS mutation in mucinous epithelial lesions of the endometrium, and analyze the correlation between KRAS mutation and the clinicopathologic features. Methods: The cohort included forty-three cases of mucinous epithelial lesions of the endometrium selected from July 2015 to October 2017 from Beijing Obstetrics and Gynecology Hospital, and 22 control cases. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue sections. Polymerase chain reaction amplification for KRAS exons 2 and 3 was performed, followed by sequencing using capillary electrophoresis. The Fisher exact test was used to compare the prevalence of KRAS mutation among the different groups. Results: The patients'age ranged from 33 to 77 years [mean (55.12±9.34) years, median 55 years]. None of the eight cases of endometrial hyperplasia with mucinous differentiation without atypia showed KRAS mutation. The frequency of KRAS mutations was 1/10 in endometrial atypical hyperplasia, 1/12 in endometrioid carcinoma, 4/11 in endometrial atypical hyperplasia with mucinous differentiation (EAHMD), 6/15 in endometrioid carcinoma with mucinous differentiation (ECMD) and 8/9 in mucinous carcinoma (MC), respectively. The differences were statistically significant between MC versus EC (P<0.01) and MC versus ECMD (P<0.05). Conclusion: The high frequency of KRAS mutation in EAHMD, ECMD and MC indicates that KRAS mutational activation is implicated in the pathogenesis of endometrial mucinous carcinoma.

Objective To explore the sonographic features, diagnosis, differential diagnosis and prognosis of placental mesenchymal dysplasia (PMD). Because ofthe lack of knowledge about the ultrasonic patterns of this kind of disease, misdiagnosis frequently happens. Throughreviewing the cases and relevant researches, we are able to understand the disease and figure it out inultrasonic images. Methods Six cases of patients with Placental mesenchymal dysplasia were reviewed which werehospitalized in Beijing Obstetrics and Gynecology Hospital during 2013 to 2017. All of the patients underwentultrasound examinations before surgery. And the diagnosisof placental mesenchymal dysplasia was confirmed by placental pathology. Inclusion criteria for the review were diagnosis of PMD as defined by placental pathology, description of placental morphology on antenatal ultrasound and reporting of pregnancy outcomes. Results All of 6 patients were found abnormal ultrasound results at routine examination of the pregnancy. The placentas were enlarged, partly with mini cysts at 12 weeks. The sonographic featurewas peak at 22 weeks, the local hive hypoechoic region of the placenta subsurface had clear border with normal placental tissue. Most of the cystic echoes of different size in the area were long circular, parallel to the distribution of the long axis of the placenta, and then the cystic change of the lesion gradually reduced, and the lesion area gradually returned to the similar state as 12 weeks of pregnancy, but it had clear border with the surrounding normal placental tissue at the 28 week of pregnancy. Some patients had umbilical vein dilation. One case PMD and fetal omphalocele suggestive of Beckwith-Wiedemann syndrome. Conclusions When a cystic placenta is detected by ultrasound examination, placental mesenchymal dysplasia should be considered in the differential diagnosis. PMD must be differentiated from gestational trophoblastic disease because management and outcomes differ. Key words: Ultrasonography; Placental mesenchymal dysplasia; Placental disease

Objective Cotyledonoid dissecting leiomyomawas a rare type of uterus tumors. Because of the lack of knowledge about the ultrasonic patterns of this kind of disease, misdiagnosis frequently happens. Reviewing the cases and relevant researches was helpful to understand the disease and figure it out in ultrasonic images. Methods Six cases of patients with dissecting leiomyoma were reviewed which were hospitalized in Beijing Obstetrics and cotyledonoid Gynecology Hospitalduring 2011 to 2016. All of the patients underwent ultrasound examinations before surgery. The ultrasound findings, clinical presentations and pathological features of the 6 patients were evaluated. Results In 6 patients with CDL, 5 cases were typical intramural dissecting leiomyomas, the inhomogeneous solid masshad irregular boundaries with muscle, color Doppler revealed intenseblood flow signals in the mass. One case exophytic component was in continuity with a lobulated, multinodular myometrial tumor with an irregular border, resembling cotyledon of the placenta. Conclusions Cotyledonoid dissecting leiomyoma was found to be inhomogeneous solid masswith irregular boundariesin some cases, exophytic component was multinodular myometrial tumor, resembling cotyledon of the placenta. Due to bizarre, sarcoma-like gross appearances. Thusit is hard to be diagnosed before surgery by ultrasonography, this type of lesion should be subjected tocareful ultrasonic examination in order to avoid over treatmentand preserve the fertility in young women.

目的 探讨特殊部位孤立性子宫囊性腺肌瘤的临床特征和腹腔镜切除病灶的有效性.方法 2002年6月～2015年6月病理诊断特殊部位孤立性子宫囊性腺肌瘤9例,年龄16～35岁,(23.4±5.9)岁.均有严重痛经,均行腹腔镜病灶切除术.结果 病灶均位于子宫圆韧带起点处或其偏下方.病灶直径2.2～4.0 cm,(3.2±0.6)cm,内见一囊腔,直径0.6～3.5 cm,(1.7±0.8)cm.病理结果显示为囊性腺肌瘤样特征,但周围肌层中除紧邻囊腔部位外均未见子宫内膜腺体和间质细胞分布.术后1个月痛经的疼痛评分由(9.8±0.6)分降至(0.4±0.7)分(P=0.004).随访2.5～11.5年,(6.6±3.2)年,无痛经和病灶复发.结论 特殊部位孤立性子宫囊性腺肌瘤是一种发生于年轻女性的可致严重痛经的罕见疾病,腹腔镜下单纯病灶切除术安全、有效.

Purpose To investigate the clinical manifesta-tions and morphologic features of placental site nodules (PSNs), and its clinical significance. Methods Twenty patients diag-nosed as PSNs were collected, then a retrospective analysis was conducted, and the characteristics of clinical data and follow-up results were analyzed,including of clinical manifestations, ultra-sonographic evaluation, morphologic and immunohistochemical features. Results The age of patients ranged from 25 to 41 years (32. 48 ± 4. 77 years in average). Three fifths of patients had pregnancy history for at least two times and the interval time to the last pregnancy ranged from 5 to 37 months (15. 33 ± 8. 05 months on average). 15 (75% ) patients went to the hospital because of abnormal vaginal bleeding. In our study, most of the samples showed a membrane-like structure without definite nod-ule. Microscopically, single or multiple, well-circumscribed and oval small nodules were found in endometrial tissue. In most ca- ses, the hyalinization was generally uniform in the center of the nodules, more or less intermediate trophoblasts appeared on the edge of the nodules. Immunohistochemically, the strong diffuse expressed CK (AE1/AE3), CAM5. 2, EMA, GATA-3, Cyclin E and p63 were detected in most of all cases, and PLAP showed strong focal expression, α-inhibin and hPL showed faint focal expression, Ki-67 staining for proliferative index was less than 4% . Conclusion PSN is a benign lesion of the intermediate trophoblast at the chorionic leave. Some diseases including hya-linized decidua, epithelioid trophoblastic tumor, and squamous cell carcinoma with hyalinization need to be identified. Some im-munohistochemical markers may be certain helpful in distinguis-hing as necessary.

Objective To investigate how to derermine the optiminal excision depth in conization of cervical high-grade squamous intraepithelial lesion(HSIL).Methods A total of 62 patients with cervical HSIL who had cold knife conization from January to December 2015 in Beijing Obstetrics and Gynecology Hospital,Capital Medical University were enrolled.All patients were divided into 3 groups according to the height of excision specimen after operation:group A(8 cases,≤1.5 cm),group B(38 cases,＞ 1.5 cm and ≤2.0 cm),group C(16 cases,＞ 2.0 cm).Postoperative pathological examination results,inner margin positive rate and the height of the highest grade cervical squamous intraepithelial lesion were analyzed.Results In 62 cases of cervical HSIL,6 cases (9.7％) were diagnosed of invasive squamous cell carcinoma according to postoperative pathological examination,13 cases(21.0％) were diagnosed as lower grade squamous intraepithelial lesion,43 cases(69.3％) had the same pathological results as before;there were no significant difference among groups (P ＞ 0.05).The inner margin positive rate in group A was significantly higher than that in group B and group C[25.0％ (2/8) vs 10.5％ (4/38),6.3％ (1/16)] (P ＜ 0.05).Totally 268 samples of HSIL were detected in 62 cases;the height range was 0.4-2.3 cm;the height in 99％ samples was less than 2.0 cm;the height in 95％ samples was less than 1.5 cm;there were no significant differences among groups(P ＞ 0.05).Conclusion 95％ cervical lesions can be removed when the excision depth is 1.5 cm in conization;99％ lesions can be removed when the excision depth is 2.0 cm;the inner margin positive rate increases when the excision depth is less than 1.5 cm.