title: Cervical nitric oxide metabolite levels and clinical variables as predictive factors of high-grade cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To create a prediction model of high-grade cervical intraepithelial neoplasia (CIN) based on clinical variables and the cervical nitric oxide metabolite (NOx) levels of study participants.
  
  
  METHODS
  This comparative study included 694 women undergoing colposcopy due to abnormal pap smear results. On the basis of the cervical biopsy results, the women were divided into the ≤ CIN 1 or CIN 2-3 group. The two groups were compared in terms of cervical NOx levels and clinical variables. Univariate, multivariate, and receiver-operating characteristic curve analysis were performed.
  
  
  RESULTS
  Multivariate analysis showed that CIN 2-3 associated with more than two cervical biopsies [odds ratio (OR) = 5.16], high-grade squamous intraepithelial lesion cytology (OR = 16.19), condom non-use (OR = 4.28), cervical NOx levels ≤ 99.9 μmol/L (OR = 16.62), more than four lifetime male sexual partners (OR = 10.56), and age at first coitus of ≤ 15 years old (OR = 3.54). This combined model had a sensitivity of 86.49 %, a specificity of 90.74 %, a positive predictive value of 64.0 %, and a negative predictive value of 97.2 %.
  
  
  CONCLUSIONS
  In the present sample, high-grade CIN associated with decreased cervical NOx levels. Thus, along with some clinical variables, cervical NOx levels may be an additional marker of cervical dysplasia.
authors.affiliation: Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Viale Martiri della Libertà 6, Scandiano, 42019, Reggio Emilia, Italy, lucazeta1976@libero.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Giannella
authors.forename: Sonia
authors.initials: S
authors.lastname: Prandi
authors.forename: Simone
authors.initials: S
authors.lastname: Giulini
authors.forename: Kabala
authors.initials: K
authors.lastname: Mfuta
authors.forename: Barbara
authors.initials: B
authors.lastname: Torrini
authors.forename: Fausto
authors.initials: F
authors.lastname: Boselli
mesh_terms: D000328:Adult; D000367:Age Factors; D001706:Biopsy; D002584:Cervix Uteri / Q000378:metabolism* / Q000473:pathology*; D003075:Coitus; D003127:Colposcopy; D017280:Condoms; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009569:Nitric Oxide / Q000378:metabolism*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology*
chemical_list: D009569:Nitric Oxide