Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years
Background: Low-grade squamous intraepithelial lesions (LSIL) are early pathological changes associated with cervical cancer, exhibiting varying progression rates. The risk factors for progression from LSIL to high-grade squamous intraepithelial lesions (HSIL) and the development...
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IMR Press
2025-05-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/52/5/10.31083/CEOG36364 |
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| author | Huaying Zhu Yunhua Fu |
| author_facet | Huaying Zhu Yunhua Fu |
| author_sort | Huaying Zhu |
| collection | DOAJ |
| description | Background: Low-grade squamous intraepithelial lesions (LSIL) are early pathological changes associated with cervical cancer, exhibiting varying progression rates. The risk factors for progression from LSIL to high-grade squamous intraepithelial lesions (HSIL) and the development of a predictive model for this progression have not been thoroughly investigated. Methods: This single-center, retrospective study followed 122 patients diagnosed with LSIL, who were monitored without treatment, over a 3-year period. Clinical and pathological data were collected, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors for progression to HSIL. A predictive model was developed based on these factors and validated using both training and validation cohorts. Results: Of the 122 patients, 11 (9.01%) progressed to HSIL within 3 years. Univariate analysis revealed that persistent high-risk human papillomavirus (HPV) infection, HPV16/18 genotype, and persistent or recurrent symptoms significantly increased the risk of progression to HSIL. Multivariate analysis confirmed that persistent high-risk HPV infection (odds ratio (OR) = 7.67, p = 0.027) and persistent or recurrent symptoms (OR = 21.07, p < 0.001) were independent risk factors for progression to HSIL. A nomogram incorporating these factors demonstrated excellent predictive performance in both the training cohort (area under the curve (AUC) = 0.92) and the validation cohort (AUC = 0.88). Calibration and decision curve analysis further validated the model’s reliability and clinical applicability. Conclusion: Persistent high-risk HPV infection and recurrent symptoms are key predictors of LSIL progression to HSIL. The developed predictive model can assist clinicians in identifying high-risk patients for early intervention, thus improving clinical management and optimizing healthcare resource utilization. |
| format | Article |
| id | doaj-art-1acb0ae6fcbc4d91b8cd67370bc609af |
| institution | OA Journals |
| issn | 0390-6663 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | IMR Press |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-1acb0ae6fcbc4d91b8cd67370bc609af2025-08-20T02:03:00ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-05-015253636410.31083/CEOG36364S0390-6663(25)02593-XObservation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 YearsHuaying Zhu0Yunhua Fu1Department of Obstetrics and Gynecology, Wu Yi Maternal & Child Care Hospital, 321200 Jinhua, Zhejiang, ChinaPhysical Examination Center, Traditional Chinese Medicine Hospital of Wuyi, 321200 Jinhua, Zhejiang, ChinaBackground: Low-grade squamous intraepithelial lesions (LSIL) are early pathological changes associated with cervical cancer, exhibiting varying progression rates. The risk factors for progression from LSIL to high-grade squamous intraepithelial lesions (HSIL) and the development of a predictive model for this progression have not been thoroughly investigated. Methods: This single-center, retrospective study followed 122 patients diagnosed with LSIL, who were monitored without treatment, over a 3-year period. Clinical and pathological data were collected, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors for progression to HSIL. A predictive model was developed based on these factors and validated using both training and validation cohorts. Results: Of the 122 patients, 11 (9.01%) progressed to HSIL within 3 years. Univariate analysis revealed that persistent high-risk human papillomavirus (HPV) infection, HPV16/18 genotype, and persistent or recurrent symptoms significantly increased the risk of progression to HSIL. Multivariate analysis confirmed that persistent high-risk HPV infection (odds ratio (OR) = 7.67, p = 0.027) and persistent or recurrent symptoms (OR = 21.07, p < 0.001) were independent risk factors for progression to HSIL. A nomogram incorporating these factors demonstrated excellent predictive performance in both the training cohort (area under the curve (AUC) = 0.92) and the validation cohort (AUC = 0.88). Calibration and decision curve analysis further validated the model’s reliability and clinical applicability. Conclusion: Persistent high-risk HPV infection and recurrent symptoms are key predictors of LSIL progression to HSIL. The developed predictive model can assist clinicians in identifying high-risk patients for early intervention, thus improving clinical management and optimizing healthcare resource utilization.https://www.imrpress.com/journal/CEOG/52/5/10.31083/CEOG36364low-grade squamous intraepithelial lesions (lsil)high-grade squamous intraepithelial lesions (hsil)hpv infectionpersistent infectionrecurrent symptomspredictive model |
| spellingShingle | Huaying Zhu Yunhua Fu Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years Clinical and Experimental Obstetrics & Gynecology low-grade squamous intraepithelial lesions (lsil) high-grade squamous intraepithelial lesions (hsil) hpv infection persistent infection recurrent symptoms predictive model |
| title | Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years |
| title_full | Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years |
| title_fullStr | Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years |
| title_full_unstemmed | Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years |
| title_short | Observation-Only Management: Risk Prediction for Progression of Low-Grade Cervical Squamous Intraepithelial Lesions to High-Grade Lesions or Malignancies within 3 Years |
| title_sort | observation only management risk prediction for progression of low grade cervical squamous intraepithelial lesions to high grade lesions or malignancies within 3 years |
| topic | low-grade squamous intraepithelial lesions (lsil) high-grade squamous intraepithelial lesions (hsil) hpv infection persistent infection recurrent symptoms predictive model |
| url | https://www.imrpress.com/journal/CEOG/52/5/10.31083/CEOG36364 |
| work_keys_str_mv | AT huayingzhu observationonlymanagementriskpredictionforprogressionoflowgradecervicalsquamousintraepitheliallesionstohighgradelesionsormalignancieswithin3years AT yunhuafu observationonlymanagementriskpredictionforprogressionoflowgradecervicalsquamousintraepitheliallesionstohighgradelesionsormalignancieswithin3years |