PAX1/JAM3基因甲基化检测对子宫颈高级别鳞状上皮内病变的预测价值OA

Objective To evaluate the predictive value of PAX1/JAM3 gene methylation testing for high-grade squamous intraepithelial lesions(HSIL)in individuals with positive cervical cancer screening results.Methods Pa⁃tients who are positive for high-risk human papillomavirus(hrHPV)and/or positive for liquid-based thin-prep cytologic test(TCT)were included.PAX1/JAM3 methylation test data were retrospectively collected from the medical record system,and histological,hrHPV,and TCT results were reviewed.Using histology as the gold standard,the sensitiv⁃ity,specificity,predictive values,and diagnostic accuracy of methylation testing for detecting cervical intraepithelial neoplasia(CIN)≥grade 2 were calculated.Results A total of 469 cases were analyzed.Methylation positivity rates increased with disease severity:2.5%(10/402)in the≤CIN1(including CIN1 and benign lesions)group,50.0%(26/52)in CIN2,and 93.3%(14/15)in the≥CIN3(including CIN3 and cancer)group.Using histology≥CIN2 as the positive standard,methylation testing showed a sensitivity of 59.7%(40/67),specificity of 97.5%(392/402),positive predictive value(PPV)of 80.0%(40/50),negative predictive value(NPV)of 93.6%(392/419),and accu⁃racy of 92.1%(432/469).Stratified sensitivity(with specificity referenced to≤CIN1)was 93.3%(14/15)for≥CIN3 and 50.0%(26/52)for CIN2.Cytology triage analysis revealed:in the atypical squamous cells cannot exclude HSIL(ASC-H)group(n=13),sensitivity and specificity were both 100.0%(5/5 and 8/8,respectively),while the negative for intraepithelial lesion or malignancy(NILM)group showed a specificity of 96.1%(198/206).Conclu⁃sion PAX1/JAM3 methylation testing demonstrates excellent sensitivity for≥CIN3(93.3%)and outstanding perfor⁃mance in ASC-H patients(100.0%sensitivity/specificity).However,its sensitivity for CIN2 is limited(50.0%),ne⁃cessitating combined strategies to mitigate missed diagnoses.