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[1]黃 勉 林 珺 沈 張 金 瓊 陶 紅 吳三山 劉禹利.PAX1基因甲基化用于子宮頸癌臨床應用價值探討[J].福建醫(yī)藥雜志,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基因甲基化用于子宮頸癌臨床應用價值探討()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期數:
2020年03期
頁碼:
3-8
欄目:
臨床研究
出版日期:
2020-07-04

文章信息/Info

Title:
Clinical application value of methylated PAX1 gene in cervical cancer
文章編號:
1002-2600(2020)03-0003-06
作者:
黃 勉 林 珺 沈 張 金 瓊 陶 紅1 吳三山 劉禹利2
福建醫(yī)科大學附屬福州市第一醫(yī)院婦產科(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
關鍵詞:
人乳頭瘤病毒;  宮頸上皮內瘤樣病變;  PAX1基因甲基化;  臨床篩查;  宮頸癌;  高危型HPV;  ASCUS
Keywords:
human papilloma virus;  cervical intraepithelial neoplasia;  PAX1 methylated gene;  cervical cancer;  high-risk HPV;  ASCUS
分類號:
R737.33
文獻標志碼:
A
摘要:
目的 探討PAX1基因甲基化、液基薄層細胞學、高危型人乳頭瘤病毒(hrHPV),與HPV16或HPV18型陽性在女性患者宮頸脫落細胞中篩查宮頸鱗狀上皮內病變的臨床應用價值。方法 選取2016年1月至2019年8月就診于本院的女性患者465例,收集宮頸脫落細胞并行PAX1基因甲基化、液基薄層細胞學、高危型HPV檢測(hrHPV)、(HPV16/18)檢測,以陽性患者進行陰道鏡下活檢病理診斷為金標準,比較宮頸脫落細胞中不同檢測方法學。結果 PAX1基因甲基化靈敏度、特異度分別為81.3%(95%CI: 70.3%, 89.1%)和96.6%(95%CI: 92.5%, 98.6%),四種檢測比較中,PAX1具有最高特異度96.63%,細胞學與hrHPV檢測特異度在17%～70%。細胞學(ASCUS+)的靈敏度為94.7%(95%CI:86.2%, 98.3%)顯著高于PAX1基因甲基化檢測(P=0.013), 但ASCUS+的特異度為18.0%(95%CI:12.8%, 24.6%)顯著低于PAX1基因甲基化檢測(P<0.001)。以PAX1、HPV16/18與hrHPV作為ASCUS分流時,PAX1具最高特異性(100% at cut off CIN2與98.9% at cut off CIN3),其次為HPV16/18。結論 本院結合細胞學與PAX1基因甲基化檢測,可以降低HPV感染需長期隨訪人群的恐慌,此結果尤其對于育齡婦女或欲保留生育人群,可提供一種有效的檢測與隨訪方法。
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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備注/Memo

備注/Memo:
基金項目:福建省自然科學基金項目(2017J01340); 福建省級臨床重點專科(婦科); 福州市婦產醫(yī)學中心建設項目(2018080301)1 湖南宏雅基因技術有限公司; 2 通信作者,Email:[email protected]; 中南大學湘雅醫(yī)學檢驗所
更新日期/Last Update: 2020-07-04