Prognostic Prediction for Recurrent/Residual CIN in HSIL Patients After Conization: An Updated Retrospective Study...

Area of Science:

• Gynecologic Oncology
• Cervical Cancer Research
• Oncogenic HPV Infections

Background:

• Limited prognostic models exist for conization in high-grade squamous intraepithelial lesion (HSIL) patients due to rapid procedure and minimal data collection.
• Developing a rapid and accurate postoperative prognostic assessment model is crucial for managing HSIL patients post-conization.

Purpose of the Study:

• To establish a rapid and accurate postoperative prognostic assessment model for patients with HSIL undergoing conization.
• To identify key predictors of recurrent or residual cervical intraepithelial neoplasia (CIN) within a 5-year follow-up period.

Main Methods:

• Retrospective study of 631 nonpregnant participants with histopathologically confirmed HSIL from January 2015 to January 2018.
• Recurrent/residual CIN categorized into residual CIN, simple recurrent CIN, and recurrent CIN with progression.
• Recurrence/residual-free survival (RFS) defined from surgery to first CIN detection or 1-/3-/5-year follow-up endpoints.

Main Results:

• LASSO regression identified higher platelet-to-lymphocyte ratio (PLR), positive margin status, and HPV-16, -18, -56, and non-HR-HPV infections as significant predictors in logistic models.
• HPV-16 infection was strongly associated with recurrent CIN and disease progression (OR = 6.159).
• Multivariate Cox regression confirmed higher PLR and HPV-16 infection as significant predictors for 1-, 3-, and 5-year follow-up (HR > 1).

Conclusions:

• HPV-16, -18, -56, and non-HR-HPV infections are key indicators for 5-year recurrent CIN risk, with HPV-16 also predicting progression.
• Preoperative PLR, gland invasion, and positive margin status may serve as predictors for recurrent/residual CIN within 1-, 3-, and 5-year follow-ups.