Cervical conization has been widely used in the treatment of cervical precancerous lesions, especially cervical electrocyclopexy (LEEP), while clinically cervical conization should include therapeutic conization and diagnostic conization, the so-called therapeutic conization is confirmed by pathological biopsy as cervical precancerous lesions, hoping to achieve therapeutic effect through surgical removal of lesions; while diagnostic conization is clinically confirmed by cervical cytology or colposcopy, etc. It is highly suspected that there is a lesion in the cervical canal and a clear diagnosis is made through cervical conization. There should be a difference in the scope of conization and conization technique. 1. Diagnostic cervical conization indications: Therapeutic conization is no longer necessary, but the indications for diagnostic conization should be considered and confirmed. into the cervical canal, and a sufficient extent of tissue should be removed. Primarily, point biopsy in the above cases does not provide reliable information, which is most often the case when cytologic diagnosis or colposcopy is considered for high-grade lesions. The indications for diagnostic conization by national experts and specialized books are: (1) cytology HSIL with negative or unsatisfactory colposcopy; (2) lesions located in the cervical canal beyond the scope of colposcopy; (3) cytology 2 grades higher than colposcopy or biopsy results; (4) cervical canal scratch results of CIN or indeterminate; (5) cytology suggestive of abnormal glandular epithelium or suspicious adenocarcinoma; (6) cervical biopsy suspicious of micro (7) cytologic and colposcopic suspicion of invasive carcinoma, which cannot be confirmed by biopsy. In conclusion, diagnostic conization of the cervix is mainly used for cervical cytology screening, colposcopy and highly clinical suspicion of cervical, especially intra-cervical ductal lesions, or biopsy suspicion of micro-infiltrating carcinoma, which requires conization to achieve large tissue removal for definite diagnosis to facilitate subsequent treatment planning. Of course, if the pathological result of conization is precancerous lesion and the cutting edge is negative, it can undoubtedly achieve the purpose of treatment at the same time. 2.Diagnostic cervical conization: Since it is for diagnosis, when the cervical biopsy is suspicious of microinfiltrative cancer, a large enough piece of tissue should be removed, and hemostasis should be exact during the operation, and sutures should be considered to stop bleeding, and excessive use of electrocoagulation is not recommended. The purpose of avoiding excessive electrocoagulation is to allow for the possibility of secondary surgery such as hysterectomy or radical hysterectomy, to reduce the pelvic congestion and edema caused by excessive electrical manipulation, and to facilitate the subsequent clinical management. If the lesion is considered in the cervical canal, diagnostic resection is needed to reach sufficient depth. Often some doctors think that diagnostic conization is just a superficial cut, which makes it difficult to achieve the diagnosis. Here are 2 cases to share. Case 1: 47 years old, TCT: HSIL, HPV: type 58 positive, colposcopy: type 3 transformation zone, cervical indication of more translucent naevus, dilatation of the cervical canal showed light vinegar white epithelium and broken cellular epithelial debris could be brought out with a small cotton swab, high suspicion of high lesion in the cervical canal. Pathology after diagnostic LEEP: excision in 2 layers to a depth of 1.8 cm, cervical cones: CIN3 involving the gland at points 8 and 9, CIN1 at points 1-7 and 10-12, no CIN was seen at the above cut edges; cervical duct cones: extensive CIN3 involving the gland, of which CIN3 was seen at the cut edges at points 1, 4, 8, 9 and 12, with no CIN at 3 points; cervical duct scratchings: CIN3. Case 2: 30 years old, 3 pregnancies and 1 delivery, TCT: HSIL, HPV: positive, cervical biopsy: CIN2-3, suspicious of early microinvasive carcinoma. Colposcopy: cervical type 2 transformation zone, thickened white acetate epithelium was seen deep in the cervical canal, and the epithelium was easily detached and bleeding when touched. Diagnostic LEEP, excision in three layers, excision depth 2.5 cm. Post-diagnostic excision pathology: cervical surface cones: 9-12 points CIN3 involving glands, negative cutting edge, 0-9 points: moderately differentiated squamous carcinoma, cancerous thrombus seen in the vasculature; superficial cervical duct: no CIN seen at 9-12 points, 0-9 points: moderately differentiated squamous carcinoma, cancerous thrombus seen in the vasculature; deep cervical duct: 0-3, 6-12 points moderately Differentiated squamous carcinoma with carcinoma thrombi seen in the vasculature, chronic cervicitis at points 3-6, individual isolated heterogeneous cell carcinoma nests seen; cervical duct scratchings: HSIL/CIS; uterine cavity scratchings: endometrium showing proliferative phase changes. In these 2 cases, their cytologic results showed high-grade lesions, but colposcopic evaluation of the cervical surface showed no obvious highly abnormal manifestations, mainly in the observation of the presence of suspicious serious lesions in the deeper part of the cervical canal, so conization requires resection of sufficient depth to reach a definitive diagnosis, and in some cases even simultaneous uterine segmental scraping is required. For cervical diagnostic conization more things need to be considered and taken care of, excision needs to be deep enough, good hemostasis, but also to leave room for further treatment, in my personal experience, LEEP can excise deeper parts, as long as the current voltage is mastered, the thermal damage of the tissue does not affect the pathological judgment, such as the specimen above, the tissue shows a light yellowish white, no active bleeding on the excision wound, it can Satisfactory results should be achieved, great importance should be attached to diagnostic cervical conization, the pathological diagnosis assessment of the excised tissue is the purpose of conization.