{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:48:43Z","timestamp":1791661723164,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Vaginal intraepithelial neoplasia 2 or worse (VaIN2+) has long remained in a largely passive diagnostic pattern due to the lack of specific clinical manifestations and routine screening strategies. This study aimed to explore its clinical characteristics and develop a prediction model for individualized risk assessment.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods<\/jats:title>\n We retrospectively analyzed the clinical characteristics and human papillomavirus (HPV) genotype distribution in 3259 women undergoing colposcopy at a single center between September 2012 and December 2024. A nomogram was developed based on predictors initially screened by least absolute shrinkage and selection operator regression and finalized through multivariable logistic regression. The model's discriminative ability, calibration, and clinical utility were assessed in both training and validation sets.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 1192 women with VaIN2+, older age, HPV infection, cytology worse than atypical squamous cells of undetermined significance (ASCUS), and concurrent cervical\/vulvar lesions were more prevalent than in 2067 women without vaginal lesions. HPV16, HPV58, HPV52, HPV33, and HPV18 were the most common genotypes. A nomogram was developed based on 10 independent predictors identified by multivariable analysis, including age, hysterectomy history, specific HPV genotypes (16, 58, 56, 35, 39), cytological results (ASCUS and worse), concurrent cervical lesions (cervical intraepithelial neoplasia 1, cervical intraepithelial neoplasia 2 or 3, cervical squamous cell carcinoma), and concurrent vulvar lesions. The nomogram demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.771 in the training set and 0.791 in the validation set. Calibration was satisfactory, and decision curve analysis confirmed superior clinical net benefit across a wide threshold probability range.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n By profiling VaIN2+ characteristics, this study developed the first prediction model integrating specific HPV genotypes with multiple clinical factors. This model enables clinicians to proactively identify high\u2010risk individuals, thereby facilitating earlier diagnosis and intervention for VaIN2+.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aogs.70371","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:59:05Z","timestamp":1791658745000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Focusing on\n VaIN2<\/scp>\n +: Development and validation of a prediction nomogram based on a large colposcopy population"],"prefix":"10.1111","author":[{"given":"Quanlong","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1775-518X","authenticated-orcid":false,"given":"Yao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyao","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pathology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-4284","authenticated-orcid":false,"given":"Zhilian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Second Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"issue":"4","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1136\/ijgc-2022-004213","article-title":"The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia","volume":"33","author":"Kesic V","year":"2023","journal-title":"Int J Gynecol Cancer"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.ejogrb.2023.03.014","article-title":"Non\u2010excisional therapeutic modalities in vaginal intraepithelial neoplasia","volume":"284","author":"Freitas G","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"3","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.ygyno.2016.03.033","article-title":"Recurrence and risk of progression to lower genital tract malignancy in women with high grade VAIN","volume":"141","author":"Hodeib M","year":"2016","journal-title":"Gynecol Oncol"},{"issue":"7","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1002\/ijc.24116","article-title":"Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta\u2010analysis","volume":"124","author":"De Vuyst H","year":"2009","journal-title":"Int J Cancer"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-025-03585-7","article-title":"Clinical characteristics and risk factors to high\u2010grade vaginal intraepithelial neoplasia: a single\u2010institution study","volume":"25","author":"Lu M","year":"2025","journal-title":"BMC Womens Health"},{"issue":"1","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-023-02714-4","article-title":"A single\u2010institutional retrospective analysis of factors related to vaginal intraepithelial neoplasia","volume":"23","author":"Zeng H","year":"2023","journal-title":"BMC Womens Health"},{"issue":"3","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/LGT.0b013e31823da7fb","article-title":"Management of vaginal intraepithelial neoplasia","volume":"16","author":"Gurumurthy M","year":"2012","journal-title":"J Low Genit Tract Dis"},{"issue":"1","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-02629-0","article-title":"Retrospective analysis of 274 cases suspected vaginal intraepithelial neoplasia","volume":"15","author":"Shen L","year":"2025","journal-title":"Sci Rep"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"8855","DOI":"10.2147\/CMAR.S335701","article-title":"Screening history in vaginal precancer and cancer: a retrospective study of 2131 cases in China","volume":"13","author":"Zhang L","year":"2021","journal-title":"Cancer Manag Res"},{"issue":"3","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00404-020-05441-5","article-title":"Accuracy of colposcopic findings in detecting vaginal intraepithelial neoplasia: a retrospective study","volume":"301","author":"Stuebs FA","year":"2020","journal-title":"Arch Gynecol Obstet"},{"issue":"2","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/CEJ.0000000000000287","article-title":"Colposcopic patterns of vaginal intraepithelial neoplasia: a study from the Italian Society of Colposcopy and Cervico\u2010Vaginal Pathology","volume":"27","author":"Sopracordevole F","year":"2018","journal-title":"Eur J Cancer Prev"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2024.1353580","article-title":"Exploring the potential prompting role of cervical human papilloma virus detection in vulvar lesions: a cross\u2010sectional study in China","volume":"14","author":"Dang X","year":"2024","journal-title":"Front Oncol"},{"issue":"16","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1001\/jama.287.16.2114","article-title":"The 2001 Bethesda system: terminology for reporting results of cervical cytology","volume":"287","author":"Solomon D","year":"2002","journal-title":"JAMA"},{"issue":"2","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1002\/jmv.27311","article-title":"A retrospective study of cytology and HPV genotypes results of 3229 vaginal intraepithelial neoplasia patients","volume":"94","author":"Ao M","year":"2022","journal-title":"J Med Virol"},{"issue":"1","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","DOI":"10.1002\/jmv.70766","article-title":"Human papillomavirus\u2010associated risk factors and clinical characteristics of vaginal intraepithelial neoplasia: a retrospective study","volume":"98","author":"Shi X","year":"2026","journal-title":"J Med Virol"},{"issue":"11","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","DOI":"10.3390\/vaccines13111089","article-title":"High\u2010grade vaginal intraepithelial neoplasia: clinical profile, HPV vaccination status, and treatment outcomes at two Italian referral centers","volume":"13","author":"Gallio N","year":"2025","journal-title":"Vaccine"},{"key":"e_1_2_13_18_1","unstructured":"ACOG Practice Advisory. American College of Obstetricians and Gynecologist.Updated Cervical Cancer Screening Guidelines.https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/practice\u2010advisory\/articles\/2021\/04\/updated\u2010cervical\u2010cancer\u2010screening\u2010guidelines#"},{"issue":"5","key":"e_1_2_13_19_1","first-page":"321","article-title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","volume":"70","author":"Fontham ETH","year":"2020","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/ijgo.13867","article-title":"Cancer of the vagina: 2021 update","volume":"155","author":"Adams TS","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.ygyno.2021.06.027","article-title":"Risk factors analysis of persistence, progression and recurrence in vaginal intraepithelial neoplasia","volume":"162","author":"Ao M","year":"2021","journal-title":"Gynecol Oncol"},{"issue":"4","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/AOG.0b013e31819bd6e0","article-title":"Human papillomavirus type\u2010distribution in vulvar and vaginal cancers and their associated precursors","volume":"113","author":"Smith JS","year":"2009","journal-title":"Obstet Gynecol"},{"issue":"2","key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/LGT.0000000000000793","article-title":"Clinical characteristics and detection sensitivity of cervical cancer screening in vaginal intraepithelial neoplasia","volume":"28","author":"Chen Y","year":"2024","journal-title":"J Low Genit Tract Dis"},{"issue":"6","key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1007\/s00404-020-05787-w","article-title":"Prevalence and distribution of human papillomavirus genotypes in cervical intraepithelial neoplasia in China: a meta\u2010analysis","volume":"302","author":"Zhang J","year":"2020","journal-title":"Arch Gynecol Obstet"},{"issue":"12","key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"3743","DOI":"10.1002\/jmv.25670","article-title":"Prevalence and genotype distribution of human papillomavirus in women with cervical cancer or cervical intraepithelial neoplasia in Henan province, central China","volume":"92","author":"Chen G","year":"2020","journal-title":"J Med Virol"},{"issue":"16","key":"e_1_2_13_26_1","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.7150\/jca.25614","article-title":"Prevalence and distribution of HPV genotypes in 1387 women with cervical intraepithelial neoplasia 2\/3 in Shanxi Province, China","volume":"9","author":"Wang Z","year":"2018","journal-title":"J Cancer"},{"issue":"18","key":"e_1_2_13_27_1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15184633","article-title":"Cytology and HPV co\u2010testing for detection of vaginal intraepithelial neoplasia: a retrospective study","volume":"15","author":"Stuebs FA","year":"2023","journal-title":"Cancers (Basel)"},{"issue":"6","key":"e_1_2_13_28_1","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.17305\/bb.2024.10523","article-title":"Influence of cervical treatment methods on subsequent vaginal lesions: a study of HPV\u2010related neoplasia","volume":"24","author":"Chen Y","year":"2024","journal-title":"Biomol Biomed"},{"issue":"14","key":"e_1_2_13_29_1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers16142524","article-title":"Vaginal intraepithelial neoplasia (VaIN) after hysterectomy is strongly associated with persistent HR\u2010HPV infection","volume":"16","author":"Bruno MT","year":"2024","journal-title":"Cancers (Basel)"},{"issue":"1","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00404-018-4936-9","article-title":"Risk factors of persistent HPV infection after treatment for high\u2010grade squamous intraepithelial lesion","volume":"299","author":"So KA","year":"2019","journal-title":"Arch Gynecol Obstet"},{"issue":"3","key":"e_1_2_13_31_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.currproblcancer.2020.100687","article-title":"Vaginal intraepithelial neoplasia in patients after total hysterectomy","volume":"45","author":"Cao D","year":"2021","journal-title":"Curr Probl Cancer"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:59:15Z","timestamp":1791658755000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,10]]},"references-count":30,"alternative-id":["10.1111\/aogs.70371"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70371","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,10]]},"assertion":[{"value":"2026-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aogs.70371"}}