高危型人乳头瘤病毒感染患者宫颈脱落细胞JAM3/PAX1高甲基化诊断宫颈高级别病变
李翔 1 ， 贺斯黎 1 ， 赵行平 1 ， 孙丹 1 ， 吴思 1 ， 徐大宝 1 ， 李颖佳 2
TL;DR 摘要总结
研究探索JAM3和PAX1基因甲基化检测在高危HPV感染患者中诊断宫颈高级别病变的临床价值。对136名患者进行回顾性分析，发现PAX1和JAM3甲基化水平与宫颈病理改变呈负相关。建立的决策树模型表明，联合JAM3/PAX1甲基化检测与液基细胞学检查可有效鉴别高级别和非高级别宫颈病变，为精准宫颈癌筛查提供新的生物标志物。
摘要 · Abstract
METHODS: A total of 136 patients who underwent gynecological examinations in the vaginal room of the Department of Gynecology at the Third Xiangya Hospital of Central South University from June 2021 to June 2022 were retrospectively studied. Among them, 122 patients had non-high-grade cervical lesions, and 14 patients had high-grade cervical lesions. The variables included general information (age, body mass index, and menopause status), LBC, high-risk human papillomavirus, cervical tissue pathology, vaginal examination results, and the ��Ct values of JAM3 and PAX1 gene methylation. Logistic regression analysis was used to identify the factors affecting the diagnosis of high-grade cervical lesions, followed by correlation analysis and construction of a conditional inference tree model
RESULTS: Logistic regression analysis showed that the methylation ��Ct values of PAX1 and JAM3 genes and LBC detection results were statistically significant between the high-grade cervical lesions group and the non-high-grade cervical lesions group (all P10.13, all of patients had non-high-grade cervical lesions, while ��CtP>6.22, the number of non-high-grade lesions accounted for 97.5% (117/120), and high-grade lesions accounted for only 2.5% (3/120). When ��CtJ>8.61 and LBC were atypical squamous cell of undetermined significance or negative for intraepithelial lesions or malignancy (NILM), 105 (99.1%) patients were non-high-grade cervical lesions, only 1 (0.9%) patient was high-grade lesion. When the results of LBC were high-grade lesions, only 9 patients' histopathological examination was the high-grade lesions and 3 non-high-grade lesions. When LBC indicated low-grade lesions, atypical squamous cell of undetermined significance, no intraepithelial lesions, and ��CtP>6.22, 117 (97.5%) of patients' histopathological examination was the non-high-grade lesions
CONCLUSIONS: The JAM3/PAX1 gene methylation test can be used independently for the stratified diagnosis of high-grade/non-high-grade cervical lesions in women with high-risk human papillomavirus infection, independent of the cytological results of cervical excision. The JAM3/PAX1 gene methylation test can also be used in combination with LBC to make up for the shortcomings of low sensitivity of LBC. In addition, the application of methylation kit in large-scale cervical cancer screening in the future will be good to the detection of more patients with high-grade cervical lesions, and achieve early screening and early treatment for cervical lesions/cancer.
发表单位
中南大学湘雅三医院
文献海报 · Poster
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