Post-Conization Study · Guilin MCH Hospital · China

Methylation Predicts Residual / Recurrence After HSIL Conization

宫颈脱落细胞基因甲基化检测对宫颈高级别病变术后残留及复发风险的预测意义
120 HSIL post-conization · 12-mo follow-up · dual-gene methylation: Se 91.3%, NPV 94.29%, AUC 0.765 · PAX1 & dual-methylation independent risk factors
Liu X, Yu X
Guilin Maternal & Child Health Hospital, Guangxi
18.33%
post-op adverse (13 residual + 9 recurred)
91.3%
Se · dual-gene prediction
94.3%
NPV · dual-gene
0.765
AUC · dual-gene

1Background & Objective

  • Problem: post-conization residual 5–15% & recurrence 3–10% — TCT/HPV follow-up is limited.
  • Objective: evaluate PAX1/JAM3 methylation to predict post-op residual & recurrence.

2Study Design & Cohort

120
HSIL patients
12 mo
follow-up
41.9y
mean age
  • Setting: Guilin MCH Hospital, Jan 2023 – Dec 2024; conization (CKC 45 / LEEP 75).
  • Assay: MSP methylation of PAX1 / JAM3 from pre-op cervical cells.
  • Outcome: residual or recurrence within 12 months (22/120).
  • HPV: hrHPV+ 87.5% (HPV16 53 · HPV18 26 · other 26).
87.5%
hrHPV+
53
HPV16
26
HPV18
26
other hrHPV
45
CKC conization
75
LEEP conization
37
canal involvement
  • Inclusion: first-diagnosed HSIL, conization, pre-op methylation, complete records.
  • Exclusion: other cancer, surgical contraindication, pregnancy, immunosuppression, invasive cancer.
  • Follow-up: 12 months — TCT/HPV + colposcopy as needed.
  • Statistics: χ² / multivariate logistic / ROC.
13
residual
9
recurred
22
adverse outcomes
  • Adverse link: methylation(+) significantly associated with post-op residual/recurrence.
  • Best predictor: dual-gene methylation — highest OR & prediction accuracy.
  • Mechanism: methylation persists in residual disease — a molecular trace.
Univariate → multivariate logistic; OR & ROC evaluation.

3Methylation Positivity

PAX1m
51.67%
JAM3m
43.33%
Dual-gene (either)
54.17%
42
single-gene positive
23
dual-gene positive

4Independent Risk Factors

Dual-gene methylation
OR 8.654
PAX1m
OR 5.892
JAM3m (ns)
ns
Multivariate: PAX1m OR 5.892 (1.985–17.596, P=0.001) · dual OR 8.654 (2.783–26.927, P<0.001).

5Dual-Gene Prediction

91.3%
Sensitivity
45.4%
Specificity
30.2%
PPV
94.3%
NPV
  • High NPV: methylation(−) → low risk of residual/recurrence — safe follow-up.
  • AUC 0.765: higher than single-gene tests — practical post-op monitoring.
  • Actionable: dual-gene(+) → intensified surveillance & earlier intervention.
Methylation complements TCT/HPV in post-conization follow-up.
Clinical Significance