Objective To evaluate the predictive power of paired box1(PAX1) and junctional adhesion molecule 3(JAM3) gene methylation as combined biomarkers for high-grade cervical intraepithelial neoplasia (CIN). Methods From July 2023 to December 2024, patients who received HPV typing testing, liquid-based cytology (TCT) testing, PAX1 and JAM3 gene methylation testing, and colposcopy pathology at Changsha Maternal and Child Health Hospital were included in this study (n=144). Methylation-specific PCR was used to quantitatively detect the methylation levels of PAX1 and JAM3 genes in cervical cells, and the combined prediction and discriminant analysis of cervical lesions were carried out by combining dichotomous variables such as HPV typing, PAX1 gene methylation and JAM3 gene methylation. Results Among the 16 pathologically confirmed CIN2 patients, the positive rates of PAX1 and JAM3 gene methylation (68.8% and 56.3%, respectively) were significantly higher than those in the CIN1 group (6.4%, 6.4%) and chronic cervicitis group (1.2%, 1.2%) (P<0.001). Among patients with high-risk HPV infection, the risk ratio for progression to CIN2 was 6.32(95% CI: 3.45-11.28) in those with positive methylation. The combined detection model showed that when HPV16/18 was positive and any gene methylation was positive, the positive predictive value of CIN2 was 96.9% (95%CI: 82.4-94.3), and the F1 value was significantly better than that of single HPV detection (59.1%) (P<0.01). Conclusion PAX1/JAM3 dual gene methylation combined with HPV typing can significantly improve the early identification ability of high-grade cervical lesions (AUC=0.8789), provide a reliable basis for molecular typing for clinical decision-making, and is especially suitable for the shunt management of cytologically uncertain cases.
Key words
cervical intraepithelial neoplasia /
methylation /
power of paired box1 /
junctional adhesion molecule3
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