Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, P.R. China; Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha 410078, P.R. China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, P.R. China.
Department of Gynaecology and Obstetrics, The Second Xiangya Hospital, Central South University, 139 Renming Road, Changsha 410011, P.R. China.
Cell Rep Med. 2023 Aug 15;4(8):101143. doi: 10.1016/j.xcrm.2023.101143. Epub 2023 Aug 8.
Effective triage of high-risk human papillomavirus (hrHPV)+ women is warranted to avoid unnecessary referral and overtreatment. Molecular triage tests have recently begun to impact cervical intraepithelial neoplasia grade 3 (CIN3) or cervical cancer (CC), termed CIN3+, detection. We find that zinc finger protein 671 methylation (ZNF671) test has superior performance for CIN3+ detection in all single molecular triage tests, including HPV16/18 genotyping, paired box gene 1 methylation (PAX1), and ZNF671, in the training set. Using ZNF671 test instead of Thinprep cytologic test (TCT) as a single triage strategy or as a combined triage strategy with HPV16/18 genotyping has achieved comparable sensitivity but higher specificity for CIN3+ detection among 391 hrHPV+ women in the validation set. Little attention has been paid to the women with hrHPV- status but detected CIN3+. We find that the CIN3+ risk after a negative result could be reduced further by triage using ZNF671 in hrHPV- patients.
有效的高危型人乳头瘤病毒（hrHPV）+女性分诊是合理的，以避免不必要的转诊和过度治疗。分子分诊测试最近开始影响宫颈上皮内瘤变 3 级（CIN3）或宫颈癌（CC），称为 CIN3+检测。我们发现锌指蛋白 671 甲基化（ZNF671）测试在所有单一分子分诊测试中具有更好的 CIN3+检测性能，包括 HPV16/18 基因分型、配对盒基因 1 甲基化（PAX1）和 ZNF671，在训练集中。在验证集中，在 391 名 hrHPV+女性中，使用 ZNF671 测试代替液基薄层细胞学检测（TCT）作为单一分诊策略，或与 HPV16/18 基因分型联合进行分诊策略，已达到可比的敏感性，但 CIN3+检测的特异性更高。对 hrHPV-但检测到 CIN3+的女性关注较少。我们发现，在 hrHPV-患者中使用 ZNF671 进行分诊可以进一步降低阴性结果后的 CIN3+风险。
