{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:08:49Z","timestamp":1788858529072,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"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: Distinguishing invasive cervical cancer from high-grade cervical intraepithelial neoplasia (CIN) before histopathology remains difficult. We evaluated routine blood-based parameters for this distinction and developed and internally validated a parsimonious prediction model, testing its incremental value over age. Methods: In this retrospective diagnostic accuracy study with two-gate (case\u2013control) sampling, we analyzed 137 unique patients with histopathologically confirmed cervical cancer and 238 with high-grade CIN after duplicate removal. A four-variable model (age, CEA, neutrophil-to-lymphocyte ratio (NLR), and hemoglobin) was developed and internally validated by bootstrap optimism correction, calibration, and decision-curve analysis, with age-matched and subgroup sensitivity analyses. Results: The strongest single discriminators were age (AUC 0.826), C-reactive protein (0.805), and albumin (0.772). The continuous model showed an apparent AUC of 0.859 (optimism-corrected 0.853; calibration slope 0.962; Brier 0.136). The gain over age alone was statistically significant but modest (\u0394AUC +0.027; DeLong p = 0.015). After 1:1 age matching, age no longer discriminated (AUC 0.49), whereas the model retained moderate discrimination (AUC 0.686), with NLR independent. Performance was lower for CIN 3 versus early-stage cancer (AUC 0.759). Conclusions: The model may provide adjunctive risk-stratification information, but clinical implementation requires external validation in prospectively assembled cohorts; the findings are hypothesis-generating.<\/jats:p>","DOI":"10.3390\/diagnostics16182884","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:10:22Z","timestamp":1788855022000},"page":"2884","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routine Blood-Based Parameters Associated with Invasive Cervical Cancer Versus High-Grade Cervical Intraepithelial Neoplasia: Development of a Retrospective Diagnostic Prediction Model"],"prefix":"10.3390","volume":"16","author":[{"given":"Isik","family":"Sozen","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Isil","family":"Turan Bakirci","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5829-9638","authenticated-orcid":false,"given":"Elif","family":"Ataseven","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Piril","family":"Ustundag","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-7025","authenticated-orcid":false,"given":"Yahya Ozgun","family":"Oner","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Busra Ebrar","family":"Hostali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7337-9977","authenticated-orcid":false,"given":"Ilkbal","family":"Temel Yuksel","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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