Risk factors for recurrent disease after loop electrosurgical excision procedure in patients with cervical intraepithelial neoplasia: a systematic review and meta-analysis.
- 1Department of Obstetrics and Gynecology 1, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
- 2The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. [email protected].
- 3Department of Obstetrics and Gynecology 1, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China. [email protected].
Abstract
Background
Loop electrosurgical excision procedure (LEEP) is a widely used treatment for cervical intraepithelial neoplasia (CIN). However, some patients remain at risk of residual or recurrent disease after treatment. Identifying predictors of recurrence is important for improving postoperative surveillance and individualized management. This systematic review and meta-analysis aimed to synthesize the available evidence on risk factors for recurrent disease after LEEP in patients with CIN.Methods
PubMed, Embase, Web of Science, Cochrane Library, Scopus, CNKI, WanFang, and VIP databases were searched from inception to February 10, 2026. Observational studies reporting factors associated with recurrent disease after LEEP in patients with CIN were eligible. Literature screening, data extraction, and quality assessment were independently conducted by two reviewers. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using Stata 15.0. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.Results
A total of 17 studies involving 8,347 patients were included. The pooled analysis showed that positive surgical margins (OR = 4.55, 95% CI: 3.00-6.90), persistent hr-HPV infection (OR = 10.44, 95% CI: 7.77-14.03), higher-grade lesions (OR = 1.85, 95% CI: 1.27-2.70), smoking (OR = 2.09, 95% CI: 1.34-3.25), and older age (OR = 1.32, 95% CI: 1.08-1.61) were significantly associated with an increased risk of recurrent disease after LEEP.Conclusions
Positive surgical margins, persistent hr-HPV infection, higher-grade lesions, and smoking appear to be important risk factors for recurrent disease after LEEP in patients with CIN. Older age may also be associated with recurrence, although this finding should be interpreted with caution because of potential publication bias. These findings may help inform postoperative risk stratification and individualized follow-up strategies in this population.
Related
- Thermal ablation versus loop electrosurgical excision procedure and cold knife conization for cervical intraepithelial neoplasia: efficacy and HPV clearance in a 5-year cohort of Chinese women
- Sentinel Lymph Node Assessment in Endometrial Intraepithelial Neoplasia/Atypical Endometrial Hyperplasia: An Updated Systematic Review and Meta-Analysis.
- Diagnostic accuracy of a systematic approach using Swedescore versus conventional colposcopy for the detection of cervical intraepithelial neoplasia grade 2 or worse: A multicenter, non‐randomized clinical study
- Cytokine Profiles in Cervical Intraepithelial Neoplasia: Associations with Lesion Severity and Exploratory Treatment Response
- HPV-Associated Tonsillar Intraepithelial Neoplasia and Oral High-Risk HPV mRNA as a Candidate Biomarker
BibTeX
@article{ge2026risk,
title = {{Risk factors for recurrent disease after loop electrosurgical excision procedure in patients with cervical intraepithelial neoplasia: a systematic review and meta-analysis.}},
author = {Yanlu Ge and Zhilei Chen and Yingping Zhu and Haiou Xu and Lifeng Li and Qun Zhou and Feifei Wang and Haimin Shi},
journal = {BMC women's health},
year = {2026},
month = jul,
doi = {10.1186/s12905-026-04689-4},
url = {https://europepmc.org/article/MED/42902321},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Risk factors for recurrent disease after loop electrosurgical excision procedure in patients with cervical intraepithelial neoplasia: a systematic review and meta-analysis.
AU - Yanlu Ge
AU - Zhilei Chen
AU - Yingping Zhu
AU - Haiou Xu
AU - Lifeng Li
AU - Qun Zhou
AU - Feifei Wang
AU - Haimin Shi
PY - 2026
DA - 2026/07/01
JO - BMC women's health
DO - 10.1186/s12905-026-04689-4
UR - https://europepmc.org/article/MED/42902321
AB - Background Loop electrosurgical excision procedure (LEEP) is a widely used treatment for cervical intraepithelial neoplasia (CIN). However, some patients remain at risk of residual or recurrent disease after treatment. Identifying predictors of recurrence is important for improving postoperative surveillance and individualized management. This systematic review and meta-analysis aimed to synthesize the available evidence on risk factors for recurrent disease after LEEP in patients with CIN.Methods PubMed, Embase, Web of Science, Cochrane Library, Scopus, CNKI, WanFang, and VIP databases were searched from inception to February 10, 2026. Observational studies reporting factors associated with recurrent disease after LEEP in patients with CIN were eligible. Literature screening, data extraction, and quality assessment were independently conducted by two reviewers. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using Stata 15.0. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.Results A total of 17 studies involving 8,347 patients were included. The pooled analysis showed that positive surgical margins (OR = 4.55, 95% CI: 3.00-6.90), persistent hr-HPV infection (OR = 10.44, 95% CI: 7.77-14.03), higher-grade lesions (OR = 1.85, 95% CI: 1.27-2.70), smoking (OR = 2.09, 95% CI: 1.34-3.25), and older age (OR = 1.32, 95% CI: 1.08-1.61) were significantly associated with an increased risk of recurrent disease after LEEP.Conclusions Positive surgical margins, persistent hr-HPV infection, higher-grade lesions, and smoking appear to be important risk factors for recurrent disease after LEEP in patients with CIN. Older age may also be associated with recurrence, although this finding should be interpreted with caution because of potential publication bias. These findings may help inform postoperative risk stratification and individualized follow-up strategies in this population.
SN - 1472-6874
ER -