Xiao Shang, Linghua Kong, Yan You, Huanwen Wu, Yuligh Liou, Xitong Jin, Pei Liu, Jinghe Lang, Lei Li
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引用次数: 0
摘要
目的：探讨DNA甲基化测定在进行机会性宫颈癌筛查的前瞻性队列中管理最低限度异常宫颈癌筛查结果的作用。方法：在机会性宫颈癌筛查妇女METHY2和METHY3筛查队列中，送宫颈细胞学样本进行高危人乳头瘤病毒（hrHPV） DNA检测、细胞学病理学检测和PAX1/JAM3 （CISCER）甲基化检测。本研究评估CISCER在处理宫颈CIN3+筛查结果轻微异常的妇女中的鉴别能力。计算一个筛查轮的绝对CIN3+风险和阴道镜转诊。结果：共有1857名宫颈轻度异常的妇女有宫颈组织学结果，并被纳入分析。在宫颈结果轻度异常的女性中，CISCER检测CIN3+的敏感性和特异性分别为74.9%（95%可信区间[CI]， 68.3% ~ 81.4%）和89.1% （95% CI 87.6% ~ 90.6%）。CISCER分析能很好地鉴别出宫颈微小异常结果，阳性结果后CIN3+风险为40.5% (95% CI 34.9%-46.2%)，阴性结果后CIN3+风险为2.7% （95% CI 2.0%-3.6%）。结论：在宫颈筛查结果轻度异常的女性中，CISCER提供了很好的CIN3+检测。在宫颈筛查结果轻微异常的妇女中使用ciser可导致直接阴道镜转诊的数量大幅减少。
Cytologic DNA methylation for managing minimally abnormal cervical cancer screening results.
Objectives: To explore the role of a DNA methylation assay for managing minimally abnormal cervical cancer screening results in a prospective cohort undergoing opportunistic cervical cancer screening.
Methods: In the cohort of the METHY2 and METHY3 screening studies of women undergoing opportunistic cervical cancer screening, cervical cytology samples were sent for high-risk human papillomavirus (hrHPV) DNA assays, cytologic pathology and methylation assays of PAX1/JAM3 (CISCER). This study evaluated the discriminative power of CISCER in managing women with minimally abnormal cervical cancer screening results for CIN3+. Absolute CIN3+ risks and colposcopy referrals within one screening round were calculated.
Results: A total of 1857 women with minimally abnormal cervical cancer findings had cervical histologic outcomes and were included in the analysis. In women with a minimally abnormal cervical cancer result, the sensitivity and specificity of CISCER was 74.9% (95% confidence interval [CI], 68.3%-81.4%) and 89.1% (95% CI 87.6%-90.6%) for detecting CIN3+. CISCER analysis discriminated well for minimally abnormal cervical cancer results, yielding a CIN3+ risk of 40.5% (95% CI 34.9%-46.2%) after a positive result and a CIN3+ risk of 2.7% (95% CI 2.0%-3.6%) after a negative result.
Conclusions: In women with a minimally abnormal cervical cancer screening result, the CISCER provides excellent detection of CIN3+. The use of CISCER in women with a minimally abnormal cervical cancer screening result can lead to a substantial reduction in the number of direct colposcopy referrals.
期刊介绍：
The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.
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