Objective  To analyze the agreement rate of grade 1 cervical intraepithelial neoplasia (CIN) diagnosed by colposcopic cervical biopsy with pathological results and the high risk factors of pathological upgrading.

  Methods  The clinical materials of 310 patients with grade 1 CIN diagnosed by colposcopic biopsy were analyzed retrospectively, and loop electrosurgical excision procedure (LEEP) was performed for all patients. The agreement rate between preoperative biopsy diagnosis and postoperative histopathology diagnosis was calculated. The related factors of patients' pathological upgrading was analyzed.

  Results  The agreement rate of preoperative biopsy diagnosis with postoperative pathological results of LEEP was 86.77% (269/310), and the pathological upgrading rate of CIN 2 and above by pathology resnlts in CIN 1 cases diagnosed by biopsy was 13.23% (41/310). Univariate analysis showed that abnormal cervical cytology before colposcopy, positive HPV16/18, menopause and unsatisfactory colposcopy were the influencing factors of pathological upgrading of patients with low grade squamous intraepithelial lesion (LSIL) diagnosed by colposcopy (P < 0.001). The results of multivariate analysis showed that abnormal cervical cytology, unsatisfactory colposcopy, menopause and positive HPV16/18 were the independent risk factors for postoperative pathological upgrading (P < 0.001).

  Conclusion  Satisfactory colposcopy, abnormal cervical cytology, menopause and positive HPV16/18 are the influencing factors of postoperative pathological upgrading.