Cervical cancer screening: eficacy of PAX1 and JAM3 methylation assay in the triage of atypical squamous cell of undetermined significance (ASC-US)
TL;DR 摘要总结
研究针对宫颈癌筛查中的不确定意义非典型鳞状细胞(ASC-US)诊断难题，评估PAX1和JAM3甲基化检测的分流效能。对322名ASC-US患者进行HPV-DNA和甲基化检测，结果显示该检测对高级别宫颈病变的敏感性为83.8%、特异性为95.8%，优于HPV检测，可将高危患者的阴道镜转诊率降低79.5%，为ASC-US患者的临床管理提供可靠补充手段。
摘要 · Abstract
BACKGROUND: Atypical squamous cells of undetermined significance (ASC-US) often present diagnostic challenges with cytology-based results, leading to potential underdiagnosis or overdiagnosis. An effective triage method is essential for managing these cases to reduce unnecessary referrals and treatment
METHODS: A total of 322 women diagnosed with ASC-US were tested for HPV-DNA and the PAX1 and JAM3 methylation (PAX1m/JAM3m) test in the study
RESULTS: Methylation levels of PAX1 and JAM3 were significantly elevated in cervical lesions classified as CIN2 or more severe lesions (CIN2+). The methylation assay demonstrated a sensitivity of 83.8% and a specificity of 95.8%, outperforming HPV-DNA testing in differentiating high-grade cervical lesions among women with ASC-US. Moreover, PAX1m/JAM3m testing significantly reduced the colposcopy referral rate for further diagnostic procedures in high-risk HPV-positive women by 79.5%
CONCLUSIONS: PAX1m/JAM3m testing shows promise as a reliable supplemental method to HPV-DNA testing for the triage of women with cytologic ASC-US. In addition, the molecular triage based on the CISCER assay or single PAX1 or JAM3 methylation, had better effects in the women with non-HPV16/18 group. This approach could potentially minimize overtreatment and unnecessary referrals in clinical practice, enhancing patient management and resource utilization.
发表单位
Zhejiang Provincial People's Hospital
引用格式
Chen, X. et al. Triage performance of PAX1m/JAM3m in opportunistic cervical cancer screening of non‒16/18 human papillomavirus-positive women: a multicenter prospective study in China. Clin Epigenetics 16, 108 (2024).
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