PAX1 甲基化检测和 HPV E6/E7 mRNA 检测在宫颈癌筛查中的应用。
The application of PAX1 methylation detection and HPV E6/E7 mRNA detection in cervical cancer screening.
机构信息
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
J Obstet Gynaecol Res. 2021 Aug;47(8):2720-2728. doi: 10.1111/jog.14869. Epub 2021 May 25.
AIM
We aimed to explore the application of PAX1 methylation and human papillomavirus (HPV) E6/E7 mRNA detection in cervical cancer screening and to compare the efficacy with high-risk (HR)-HPV detection.
PATIENTS AND METHODS
The cervical exfoliative cytology samples of 337 patients were collected, including 70 cases of cervical inflammation, 72 cases of low-grade squamous intraepithelial lesions, 97 cases of high-grade squamous intraepithelial lesions, and 98 cases of cervical carcinoma. The PAX1 gene methylation (PAX1) status was detected by multiple quantitative PCR, HPV E6/E7 mRNA (E6/E7) was detected by QuantiVirus detection, and HR-HPV (HPV) was detected by the Cobas 4800 detection system. The sensitivities, specificities, and accuracies were validated in the testing set.
RESULTS
The sensitivities of the HPV, HPV E6/E7, and PAX1 testing were 89.23%, 84.10%, and 86.67%, respectively, which all maintained a high level. In contrast, the specificities of the HPV, E6/E7, and PAX1 testing were only 19.10%, 37.32%, and 97.18% (in pairwise comparisons, p = 0.000). The AUC of PAX1 (0.919) was significantly larger than that of HPV (0.541) and E6/E7 detection (0.607) (p < 0.0001). In addition, the AUC areas of all combined parallel testing were lower than that of single PAX1 test (p < 0.05).
CONCLUSION
The diagnostic efficacy of E6/E7 detection and PAX1 detection was better than that of HPV detection, especially for PAX1 detection.
目的
探讨 PAX1 甲基化和人乳头瘤病毒（HPV）E6/E7mRNA 检测在宫颈癌筛查中的应用，并与高危型（HR）HPV 检测进行比较。
方法
收集 337 例宫颈脱落细胞学标本，包括宫颈炎 70 例、低级别鳞状上皮内病变 72 例、高级别鳞状上皮内病变 97 例和宫颈癌 98 例。采用多重实时定量 PCR 检测 PAX1 基因甲基化（PAX1）状态，采用 QuantiVirus 检测 HPV E6/E7mRNA（E6/E7），采用 Cobas 4800 检测系统检测 HR-HPV（HPV）。在检测集中验证了敏感性、特异性和准确性。
结果
HPV、HPV E6/E7 和 PAX1 检测的敏感性分别为 89.23%、84.10%和 86.67%，均保持较高水平。相比之下，HPV、E6/E7 和 PAX1 检测的特异性仅为 19.10%、37.32%和 97.18%（两两比较，p=0.000）。PAX1 的 AUC（0.919）明显大于 HPV（0.541）和 E6/E7 检测（0.607）（p<0.0001）。此外，所有并联联合检测的 AUC 面积均低于单 PAX1 检测（p<0.05）。
结论
E6/E7 检测和 PAX1 检测的诊断效能优于 HPV 检测，尤其是 PAX1 检测。
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