PAX1甲基化检测对细胞学异常(ASCUS、LSIL和ASC-H)患者的分流作用

目的:探讨配对盒基因家族1(PAX1)甲基化检测在细胞学异常女性中的分流作用.方法:选取212例宫颈细胞学(TCT)诊断为意义未明的不典型鳞状细胞(AS-CUS)、不除外高度鳞状上皮内病变(ASC-H)、低度鳞状上皮内病变(LSIL)的病例进行PAX1甲基化检测和高危HPV检测,进行阴道镜检查和宫颈活检.以组织病理结果...

Shunt effect of PAX1 methylation detection on patients with cytological abnormalities(ASCUS,LSIL and ASC-H)

Objective:To investigate the shunt effect of PAX1 methylation detection in women with abnormal cytology.Methods:212 patients with atypical squamous cell(ASCUS),high-grade squamous intraepithelial lesion(ASC-H)or low-grade squamous intraepithelial lesion(LSIL)diagnosed by cytological(TCT)were examined by PAX1 methylation and high-risk HPV,followed by colposcopy and cervical biopsy.Using pathological biopsy as the gold standard,the efficacy of PAX1 and high-risk HPV in detecting HSIL+(HSIL and cervical squamous cell carcinoma)was compared.Results:The positive rate of PAX1 in the LSIL group(chronic cervicitis and LSIL)was 7.25%(10/138),which was significantly lower than that in the HSIL+group(86.49%)(64/74)(P<0.05).The positive rate of HPV in LSIL group was 69.57%(96/138),which was significantly lower than that in HSIL+group(89.19%)(66/74)(P<0.05).The sensitivity of PAX1 in diagnosing HSIL+(86.49%)was not significantly different from that of high-risk HPV(89.19%),but the specificity,accuracy and AUC(92.75%,90.56%,0.896)were significantly higher than those of high-risk HPV(30.43%,50.94%and 0.598)(P<0.05).When PAX1 methylation was used instead of HPV test for cytological shunt,the colposcopy referral rate can be reduced to 34.91%.When the cytological results were ASCUS,LSIL and ASC-H,the diagnostic accuracy of HSIL+by PAX1(84.21%,91.30%,100%)was significantly higher than that of high risk HPV(63.15%,34.78%,63.64%)(P<0.05).Conclusion:The methylation of PAX1 gene has high sensitivity and specificity.In women with cytological abnormalities(ASCUS,LSIL,ASC-H),PAX1 methylation detection can improve the detection rate of HSIL+,and its diagnostic efficiency is better than that of high risk HPV detection,and can reduce the referral rate of colposcopy.