DNA methylation for cervical cancer screening: a training set in China
DNA methylation for cervical cancer screening: a training set in China
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DOI：
10.1186/s13148-020-00885-7
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发表时间：
2020-06-23
影响因子：
5.7
通讯作者：
Li, Lei
中科院分区：
文献类型：
--
作者：
Kong, Linghua;Wang, Linhai;Li, Lei
背景：尽管用于宫颈癌筛查的DNA甲基化工具快速改进，但使用两种宿主基因EPB 41 L3和JAM 3的组合进行的可靠的探索性研究很少，这是新开发的检测方法。方法对2018年3月至2019年3月研究中心门诊的异常液基细胞学和/或高危型人乳头瘤病毒（hrHPV）数据进行审查。纳入具有明确组织病理学结果的合格患者，并评估其残留细胞学样本的EPB 41 L3和JAM 3甲基化。比较了各种筛查策略对明确病理学和宫颈上皮内瘤样病变（CIN）2或更严重病变（CIN 2+）的诊断准确性。结果共检测成功306例，最终纳入301例宫颈组织病理学检查，其中炎症/CIN 1和CIN 2+分别为118例（39.2%）和183例（60.8%）。关于CIN 2+检测，甲基化状态和hrHPV加甲基化具有相似的阳性预测值（分别为0.930和0.954，p= 0.395）。此外，hrHPV、甲基化和hrHPV+甲基化的阴性预测值相似（分别为0.612、0.679和0.655，p = 0.677），显著高于单独细胞学检查的阴性预测值（分别为0.250，p值0.012、0.001和0.001）。对于49例hrHPV结果阴性的病例，仅阳性甲基化就能够区分CIN 2+和炎症/CIN 1。结论EPB 41 L3和JAM 3甲基化检测是一种准确可行的CIN 2+筛查方法。
Background Despite rapid improvements in DNA methylation tools for cervical cancer screening, few robust, exploratory studies have been performed using the combination of two host genes,EPB41L3andJAM3, newly developed assays. Methods A review of abnormal liquid-based cytology and/or high-risk human papillomavirus (hrHPV) data from outpatient clinics in the study center from March 2018 to March 2019 was performed. Eligible patients with definitive histological pathology results were included, and their residual cytology samples were assessed forEPB41L3andJAM3methylation. The diagnostic accuracies of various screening strategies for definitive pathology and for cervical intraepithelial neoplasia (CIN) 2 or more severe lesions (CIN2+) were compared. Results In total, 306 patients were successfully tested; 301 cases with cervical histological pathology were included in the final analysis, including 118 (39.2%) and 183 (60.8%) cases of inflammation/CIN1 and CIN2+, respectively. Regarding CIN2+ detection, methylation status and hrHPV plus methylation had similar positive predictive values (0.930 and 0.954, respectively,p= 0.395). Additionally, hrHPV, methylation, and hrHPV plus methylation had similar negative predictive values (0.612, 0.679, and 0.655,p= 0.677) that were significantly higher than that of cytology alone (0.250,pvalues 0.012, 0.001, and 0.001, respectively). For 49 cases with negative hrHPV results, positive methylation alone was able to differentiate CIN2+ from inflammation/CIN1. Conclusions Methylation of bothEPB41L3andJAM3is an accurate and feasible screening method for CIN2+.