HPV分型检测联合血清CCNA2、GATA2对宫颈癌的早期诊断价值OA

Objective To explore the early diagnostic value of human papillomavirus(HPV)typing detection com-bined with serum cyclin A2(CCNA2)and GATA binding protein 2(GATA2)for cervical cancer(CC).Methods A total of 315 patients with CC treated in the Department of Gynecology,First Hospital of Shanxi Medical University from July 2022 to July 2025 were consecutively enrolled as the CC group.Simultaneously,315 patients with cervical benign lesions during the same period were selected as the control group(N-CC group).HPV genotyping gene chip technology was used to detect HPV subtypes in cervical secretions.ELISA was employed to determine serum levels of CCNA2 and GATA2.Receiver operating characteristic(ROC)curve analysis was used to evaluate the early diagnostic efficacy of HPV genotyping,CCNA2,and GATA2 individually and in combination for CC.The Kappa consistency test was applied to analyze the agreement between the above indicators and pathological diagnosis results.The bootstrap resampling technique was used for internal validation of the model,combined with the Hosmer-Lemeshow goodness-of-fit test to assess model calibration capability,comprehensively veri-fying the robustness of the diagnostic model.The interaction between serum CCNA2 and GATA2 levels in the early diagnosis of CC patients was analyzed.Results The HPV-positive rate was 15.24％in the N-CC group,which was significantly lower than that in the CC group(80.00％)(x2=264.829,P＜0.001).Serum CCNA2 and GATA2 levels were significantly higher in the CC group than in the N-CC group(t for CCNA2=13.355,t for GATA2=13.731,both P＜0.001).The AUCs for early diagnosis of CC by HPV genotyping,serum CCNA2,GATA2,and their combination were 0.824,0.766,0.785,and 0.935,re-spectively.The combined diagnosis was superior to each method alone(Z=9.655,9.699,9.030,all P＜0.001).HPV genotyping,serum CCNA2,and GATA2 individually detected 252,232,and 238 CC cases,with agreement to pathological diagnosis being high(Kappa=0.648),fair(Kappa=0.397),and moderate(Kappa=0.460),respectively.The combination of all three detec-ted 293 CC cases,showing the highest agreement with pathological diagnosis(Kappa=0.724,P＜0.001).Internal validation showed the calibration curve indicated a high consistency between predicted and observed risks,and the Hosmer-Lemeshow goodness-of-fit test(x2=14.762,df=8,P=0.064)further confirmed good calibration of the model.Patients with co-high ex-pression of CCNA2 and GATA2 had a 12.26 times higher risk of developing CC compared to those with low expression of both.Interaction analysis indicated a significant synergistic effect between the two(RERI=7.03,SI=2.66),with 57.00％of the disease risk attributable to the interaction between CCNA2 and GATA2.Conclusion HPV typing detection combined with serum CCNA2 and GATA2 demonstrates superior diagnostic efficiency in the early identification of CC.