Toexplore the factors influencing the persistence and progression of low-grade cervical intraepithelial neoplasia (CIN1), and to construct and validate a Nomogram prediction model therefor.
A total of 564 patients with histopathologically confirmed CIN1 were enrolled from a community-based cohort of married women in Jiexiu City, Shanxi Province, between June and December 2022. All patients underwent pathological re-examination at 12 months, and their CIN1 lesions showed three outcomes: regression, persistence or progression. The study population was divided into a training set and a validation set at a ratio of 7:3. Lasso regression was used to screen predictor variables associated with the risk of CIN1 persistence and progression, and a Nomogram model was constructed using multivariate Logistic regression analysis.The model was evaluated using the concordance index(C-index), Hosmer-Lemeshow (H-L) test, calibration curves, and receiver operating characteristic (ROC) curves.
After applying the inclusion and exclusion criteria, a total of 479 participants were enrolled in this study, with 335 assigned to the training set and 144 to the validation set. Lasso-Logistic regression identified serum folate level, HR-HPV infection, genital cleaning frequency, underwear change frequency, and gynecological history as variables associated with CIN1 persistence and progression. The internally validated C-index of the constructed Nomogram was 0.767, indicating good predictive performance.The H-L test showed a good fit of the model (χ2=1.447, P=0.485). The calibration curves of both the training and validation sets were close to the ideal diagonal, indicating good calibration. The areas under the ROC curves for the training and validation sets were 0.784 (95% CI:0.734-0.835) and 0.815 (95% CI:0.736-0.895), respectively, demonstrating good discriminative ability.
Serum folate level, HR-HPV infection, genital cleaning frequency, underwear change frequency, and gynecological history are significant predictive variables for persistence and progression of CIN1.The constructed Nomogram can intuitively predict the incidence of CIN1 persistent or progression in patients, providing a theoretical reference for the prevention, treatment, and individualized management of early cervical lesions.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |