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HPV16 L1 和 L2 DNA 甲基化预测细胞学轻度异常的女性中高级别宫颈上皮内瘤变。

HPV16 L1 and L2 DNA methylation predicts high-grade cervical intraepithelial neoplasia in women with mildly abnormal cervical cytology.

机构信息

Queen Mary University of London, Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, London, EC1M 6BQ, United Kingdom.

出版信息

Int J Cancer. 2013 Aug 1;133(3):637-44. doi: 10.1002/ijc.28050. Epub 2013 Mar 7.

Abstract

DNA methylation changes in human papillomavirus type 16 (HPV16) DNA are common and might be important for identifying women at increased risk of cervical cancer. Using recently published data from Costa Rica we developed a classification score to differentiate women with cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) from those with no evident high-grade lesions. Here, we aim to investigate the performance of the score using data from the UK. Exfoliated cervical cells at baseline and 6-months follow-up were analyzed in 84 women selected from a randomized clinical trial of women undergoing surveillance for low-grade cytology. Selection of women for the methylation study was based on detectable HPV16 in the baseline sample. Purified DNA was bisulfite converted, amplified and pyrosequenced at selected CpG sites in the viral genome (URR, E6, L1 and L2), with blinding of laboratory personnel to the clinical data. The primary measure was a predefined score combining the mean methylation in L1 and any methylation in L2. At the second follow-up visit, 73/84 (87%) women were HPV16 positive and of these 25 had a histopathological diagnosis of CIN2/3. The score was significantly associated with CIN2/3 (area under curve = 0.74, p = 0.002). For a cutoff with 92% sensitivity, colposcopy could have been avoided in 40% (95% CI 27-54%) of HPV16 positive women without CIN2/3; positive predictive value was 44% (32-58%) and negative predictive value was 90% (71-97%). We conclude that quantitative DNA methylation assays could help to improve triage among HPV16 positive women.

摘要

人乳头瘤病毒 16 型(HPV16)DNA 中的 DNA 甲基化变化很常见,对于识别宫颈癌风险增加的女性可能很重要。利用哥斯达黎加最近发表的数据,我们开发了一种分类评分,以区分宫颈上皮内瘤变 2 级或 3 级(CIN2/3)的女性和没有明显高级别病变的女性。在这里,我们旨在使用英国的数据来研究该评分的性能。在一项针对接受低级别细胞学监测的女性的随机临床试验中,从 84 名女性中分析了基线和 6 个月随访时的脱落宫颈细胞。选择用于甲基化研究的女性是基于基线样本中可检测到的 HPV16。用亚硫酸氢盐对纯化的 DNA 进行转化、扩增,并在病毒基因组的选定 CpG 位点(URR、E6、L1 和 L2)进行焦磷酸测序,实验室人员对临床数据进行盲法处理。主要测量值是结合 L1 中平均甲基化和 L2 中任何甲基化的预定义评分。在第二次随访时,84 名女性中有 73 名(87%)HPV16 阳性,其中 25 名有 CIN2/3 的组织病理学诊断。该评分与 CIN2/3 显著相关(曲线下面积=0.74,p=0.002)。对于 92%灵敏度的截止值,可以避免 40%(95%CI 27-54%)无 CIN2/3 的 HPV16 阳性女性进行阴道镜检查;阳性预测值为 44%(32-58%),阴性预测值为 90%(71-97%)。我们得出结论,定量 DNA 甲基化测定可以帮助改善 HPV16 阳性女性的分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/985b/3708123/ec897dddd07f/ijc0133-0637-f1.jpg

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