{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T21:33:57Z","timestamp":1782250437755,"version":"3.54.5"},"reference-count":43,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The diagnostic performance of CINtec\u00ae PLUS can be influenced by numerous patient characteristics and risk factors. The aim of this retrospective study was to evaluate and model the risk factors associated with CINtec\u00ae PLUS test positivity in patients undergoing cervical cancer screening and to assess their predictive performance for the prediction of cervical intraepithelial neoplasia (CIN) 2\/3 using an unsupervised machine learning-based model. Methods: Medical data of 134 patients with human papillomavirus (HPV) infection who underwent CINtec\u00ae PLUS testing were used to model the impact of risk factors on dual-stain cytology positivity and to evaluate the predictive performance for CIN2\/3. Results: The gradient boosting classifier for the prediction of CINtec\u00ae PLUS positivity using clinical risk factors had a precision of 75%, an overall accuracy of 0.62, and an area under the curve (AUC) value of 0.77. Body mass index and age were the most important variables in this model. HSIL, ASC-US, and other high-risk HPV strains increased the likelihood of a positive outcome. Overall AUC values for a positive test alone were 0.74 and 0.69 for CIN2 and CIN3 prediction, respectively. For CIN2 prediction, the XGBoost model performed well, with 71% sensitivity, 85% specificity, and an AUC value of 0.90. However, the model had 96% sensitivity, 25% specificity, and 0.58 AUC for CIN3 prediction. Conclusions: Patient characteristics and risk factors can influence CINtec\u00ae PLUS positivity rates and they need to be carefully considered before choosing a specific management.<\/jats:p>","DOI":"10.3390\/diagnostics15172200","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:18:15Z","timestamp":1756484295000},"page":"2200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical and Virological Profiles Associated with CINTEC\u00ae PLUS Positivity: A Data-Driven Clustering and Modeling Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Iulian-Valentin","family":"Munteanu","sequence":"first","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-0200","authenticated-orcid":false,"given":"Demetra","family":"Socolov","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Care, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8969-8016","authenticated-orcid":false,"given":"Razvan","family":"Socolov","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Care, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Adam","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2118-2693","authenticated-orcid":false,"given":"Gigi","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4718-392X","authenticated-orcid":false,"given":"Ingrid-Andrada","family":"Vasilache","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Care, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petronela","family":"Vicoveanu","sequence":"additional","affiliation":[{"name":"Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, \u2018\u0218tefan cel Mare\u2019 University, 720229 Suceava, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeriu","family":"Harabor","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3405-9097","authenticated-orcid":false,"given":"Anamaria","family":"Harabor","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina-Mihaela","family":"Calin","sequence":"additional","affiliation":[{"name":"Clinical and Surgical Department, Faculty of Medicine and Pharmacy, \u2018Dunarea de Jos\u2019 University, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.mrrev.2016.08.001","article-title":"Molecular mechanisms underlying human papillomavirus E6 and E7 oncoprotein-induced cell transformation","volume":"772","author":"Mittal","year":"2017","journal-title":"Mutat. 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