Assessment of PAX1 and JAM3 methylation triage efficacy across HPV genotypes and age groups in high-risk HPV-positive women in China
TL;DR 摘要总结
研究评估PAX1/JAM3甲基化检测在高危HPV阳性女性宫颈病变筛查中的临床价值。对436名受试者进行检测，结果显示该方法对CIN2+病变的敏感性达92.6%，特异性95.7%，优于细胞学检查。在HPV16/18阳性和非16/18阳性女性中均表现优异，且能识别所有宫颈癌病例。该检测方法在宫颈脱落细胞中的应用显示出优于传统筛查策略的分流性能。
摘要 · Abstract
OBJECTIVE: This study aimed to evaluate the clinical utility of PAX1/JAM3 methylation (CISCER) test in triaging high-risk human papillomavirus (hrHPV)-positive women
METHODS: We enrolled women who underwent opportunistic screening at Cervical Disease outpatient clinics of Xuzhou Maternity and Child Health Hospital, and Yueyang Central Hospital from December 2022 to May 2024. The effectiveness of CISCER and cytology tests in triaging hrHPV+ patients was analyzed
RESULTS: Among the 436 study participants, 283 (64.9%) had no cervical intraepithelial neoplasia (CIN), while 53 (12.2%) had CIN1, 40 (9.2%) had CIN2, 34 (7.8%) had CIN3, and 26 (5.9%) had cervical cancers. The CISCER tests identified all cases of cervical cancer, particularly 2 hrHPV-negative adenocarcinoma cases. In 396 hrHPV+ individuals, the sensitivity of CISCER tests for detecting CIN2+ lesions was 92.6% (95% CI: 87.2-97.9%), with a specificity of 95.7% (95% CI: 93.4-98%), and an area under the receiver operating characteristic curve (AUC) of 0.941 (95% CI: 0.903-0.979), outperforming cytology tests in both HPV16/18+ and non-16/18 hrHPV+ women. Notably, CISCER demonstrated 100% (95% CI: 90-100%) sensitivity in women aged��50 and 100% (95%CI: 93.6-100%) specificity in women aged<30. Among CIN2+ women, 37.2% (including 3 cancer) showed low-grade cytological changes that could be detected by CISCER. Meanwhile, 52% of CIN2- women exhibited cytological abnormalities but had negative CISCER results. The immediate CIN3+ risk based on positive CISCER results was 54% (95% CI: 43.8-63.9%)
CONCLUSION: The PAX1/JAM3 methylation detection using cervical exfoliated cells showed superior triage performance for hrHPV-positive patients compared to traditional strategies.
发表单位
Department of Cervical Disease, Xuzhou Maternity and Child Health Hospital, Jiangsu, China, 2Department of Gynecology, Yueyang Central Hospital, Hunan, China, 3
引用格式
Liang, H. et al. Assessment of PAX1 and JAM3 methylation triage efficacy across HPV genotypes and age groups in high-risk HPV-positive women in China. Front Oncol 14, 1481626 (2024).
文献海报 · Poster
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