[1]黄 勉 林 珺 沈 张 金 琼 陶 红 吴三山 刘禹利.PAX1基因甲基化用于子宫颈癌临床应用价值探讨[J].福建医药杂志,2020,42(03):3-8.
　HUANG Mian,LIN Jun,SHEN Zhang,et al.Clinical application value of methylated PAX1 gene in cervical cancer[J].FUJIAN MEDICAL JOURNAL,2020,42(03):3-8.
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PAX1基因甲基化用于子宫颈癌临床应用价值探讨()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年03期
页码:
3-8
栏目:
临床研究
出版日期:
2020-07-04

文章信息/Info

Title:
Clinical application value of methylated PAX1 gene in cervical cancer
文章编号:
1002-2600(2020)03-0003-06
作者:
黄 勉 林 珺 沈 张 金 琼 陶 红1 吴三山 刘禹利2
福建医科大学附属福州市第一医院妇产科(福州 350009)
Author(s):
HUANG Mian; LIN Jun; SHEN Zhang; JIN Qiong; TAO Hong;  WU SanShan;  LIU Yuli.
Department of Gynecology,the First Hospital of Fuzhou,Fuzhou,Fujian 350009,China
关键词:
人乳头瘤病毒;  宫颈上皮内瘤样病变;  PAX1基因甲基化;  临床筛查;  宫颈癌;  高危型HPV;  ASCUS
Keywords:
human papilloma virus;  cervical intraepithelial neoplasia;  PAX1 methylated gene;  cervical cancer;  high-risk HPV;  ASCUS
分类号:
R737.33
文献标志码:
A
摘要:
目的 探讨PAX1基因甲基化、液基薄层细胞学、高危型人乳头瘤病毒(hrHPV),与HPV16或HPV18型阳性在女性患者宫颈脱落细胞中筛查宫颈鳞状上皮内病变的临床应用价值。方法 选取2016年1月至2019年8月就诊于本院的女性患者465例,收集宫颈脱落细胞并行PAX1基因甲基化、液基薄层细胞学、高危型HPV检测(hrHPV)、(HPV16/18)检测,以阳性患者进行阴道镜下活检病理诊断为金标准,比较宫颈脱落细胞中不同检测方法学。结果 PAX1基因甲基化灵敏度、特异度分别为81.3%(95%CI: 70.3%, 89.1%)和96.6%(95%CI: 92.5%, 98.6%),四种检测比较中,PAX1具有最高特异度96.63%,细胞学与hrHPV检测特异度在17%～70%。细胞学(ASCUS+)的灵敏度为94.7%(95%CI:86.2%, 98.3%)显著高于PAX1基因甲基化检测(P=0.013), 但ASCUS+的特异度为18.0%(95%CI:12.8%, 24.6%)显著低于PAX1基因甲基化检测(P<0.001)。以PAX1、HPV16/18与hrHPV作为ASCUS分流时,PAX1具最高特异性(100% at cut off CIN2与98.9% at cut off CIN3),其次为HPV16/18。结论 本院结合细胞学与PAX1基因甲基化检测,可以降低HPV感染需长期随访人群的恐慌,此结果尤其对于育龄妇女或欲保留生育人群,可提供一种有效的检测与随访方法。
Abstract:
Objective To investigate the clinical application values of methylation of PAX1 gene, liquid-based cytology, high-risk human papilloma virus(hrHPV), and HPV16/18 genotyping tests for cervical intraepithelial lesions screening using exfoliated cells.Methods A total of 465 women were enrolled in the First Hospital of Fuzhou from January 2016 to August 2019.The cervical exfoliated cells were collected for PAX1 gene methylation, liquid-based cytology, high-risk HPV, and HPV16/18 genotyping tests in the study.Compared the different tests with colposcopy biopsy pathological diagnosis was showed in this paper.Results The sensitivity and specificity of methylated PAX1 gene were 81.3%(95%CI: 70.3%, 89.1%)and 96.6%(95%CI: 92.5%, 98.6%).The methylated PAX1 gene had the highest specificity of 96.63% in the four compared tests.The specificity of liquid-based cytology and hrHPV detection were ranged from 17% to 70%.The sensitivity of cytology(ASCUS +)(94.7%, 95%CI: 86.2%, 98.3%)was significantly higher than the methylated PAX1 gene test(P=0.013), but the specificity of cytology(ASCUS +)(18.0%, 95%CI: 12.8%, 24.6%)was significantly lower than the methylated PAX1 gene test(P<0.001).When methylated PAX1 gene, HPV16/18 and hrHPV tests were used as triage tools for ASC, the methylated PAX1 gene test had the highest specificity(100% at cut off CIN2 and 98.9% at cut off CIN3), followed by HPV16/18.Conclusion Combining cytology and PAX1 gene methylation detection in our hospital can reduce the panic of people with long-term follow-up of high risk HPV infection.This result provides a hospital evidance and follow-up methodology to reduce panic women especially for women want to keep fertility.

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备注/Memo

备注/Memo:
基金项目:福建省自然科学基金项目(2017J01340); 福建省级临床重点专科(妇科); 福州市妇产医学中心建设项目(2018080301)1 湖南宏雅基因技术有限公司; 2 通信作者,Email:1265676573@qq.com; 中南大学湘雅医学检验所
更新日期/Last Update: 2020-07-04