Triage performance of DNA methylation for women with high-risk human papillomavirus infection.

IF 4.8 2区医学 Q1 ONCOLOGY Oncologist Pub Date : 2024-11-27 DOI:10.1093/oncolo/oyae324

Linghua Kong, Xiaoping Xiao, Huanwen Wu, Yan You, Xitong Jin, Yuligh Liou, Pei Liu, Jinghe Lang, Lei Li

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Abstract

Objective: DNA methylation is a promising biomarker for cervical cancer screening. This study aimed to validate the triage performance of cytological DNA methylation for detecting cervical intraepithelial neoplasia of grade 3 or worse (CIN3+) in women with high-risk human papillomavirus (hrHPV) infection from a large prospective cohort undergoing opportunistic screening in China (METHY3).

Methods: The triage performance for detecting CIN3+ lesions was compared between HPV16/18 genotyping, a liquid-based cytology (LBC) test, and the PAX1 and JAM3 methylation (PAX1m/JAM3m) test according to cervical pathologic outcomes. Among the 4394 women infected with hrHPV, 1105 had definitive cervical histological findings that were analyzed.

Results: For detecting CIN3+, the specificity of HPV16/18(+), the LBC result of ≥atypical squamous cells of undetermined significance (ASCUS), and PAX1m/JAM3m(+) was 66.4%, 23.9%, and 89.6%, respectively, with odds ratios of 4.24 (95% confidence interval [CI], 2.85-6.40), 4.44 (2.27-10.1), and 18.5 (12.1-28.7) (P < .001), respectively. PAX1m/JAM3m(+) had the highest area under the receiver operating characteristic curve (0.790, 95% CI, 0.747-0.832) in the whole cohort and in women of various ages. PAX1m/JAM3m (+) was detected in all patients with cancer (n = 28). Compared with HPV16/18 genotyping and the LBC test, PAX1m/JAM3m testing reduced referrals to colposcopy by 20.64 percentage points and 61.18 percentage points, respectively.

Conclusions: PAX1 m /JAM3 m testing is highly specific for detecting CIN3+. As a triage biomarker, it is superior to HPV 16/18 genotyping and LBC testing for women with hrHPV infection.

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高危人类乳头瘤病毒感染妇女 DNA 甲基化的分流性能。

目的：DNA甲基化是宫颈癌筛查的一种有前景的生物标记。本研究旨在验证细胞学DNA甲基化检测3级或更严重宫颈上皮内瘤变（CIN3+）的分级性能，该检测来自中国一个大型前瞻性机会性筛查队列（METHY3）中的高危人乳头瘤病毒（hrHPV）感染妇女：根据宫颈病理学结果，比较了HPV16/18基因分型、液基细胞学（LBC）检测和PAX1与JAM3甲基化（PAX1m/JAM3m）检测在检测CIN3+病变方面的分流效果。在 4394 名感染 hrHPV 的妇女中，有 1105 人的宫颈组织学结果得到了明确的分析：对于检测 CIN3+，HPV16/18(+)、LBC 结果为≥意义未定的非典型鳞状细胞（ASCUS）和 PAX1m/JAM3m(+) 的特异性分别为 66.4%、23.9% 和 89.6%，几率比分别为 4.24（95% 置信区间[CI]，2.85-6.40）、4.44（2.27-10.1）和 18.5（12.1-28.7）（PPAX1 m /JAM3 m检测对检测CIN3+具有高度特异性。作为一种分流生物标志物，它优于HPV 16/18基因分型和LBC检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.