阴道镜与PAX1基因甲基化对宫颈上皮内瘤病变的临床应用价值研究

Study on the clinical application value of colposcopy and methylation of PAX1 gene on the lesion of CIN

目的:探讨宫颈上皮内瘤变(CIN)患者使用阴道镜检查与PAX1基因甲基化检验的临床价值。方法:选取200例行宫颈疾病检查的女性患者展开研究,所有患者均实施单独阴道镜检查、单独PAX1基因甲基化检测和阴道镜检查+PAX1基因甲基化检测,观察其临床学应用价值,使用阴道镜检查和PAX1基因甲基化检验患者的宫颈病变,联合两种检查方式同时检验,以病理学检验结果作为金标准,比较3种检查方式的检验灵敏度、特异度、诊断符合率以及漏诊率。结果:阴道镜检查阳性结果为24例(占12%),PAX1基因甲基化检验阳性结果为20例(占10%),阴道镜+PAX1基因甲基化检验阳性结果为36例(占18%)。其中,阴道镜+PAX1基因甲基化检验的灵敏度为100%,明显高于其他两种检测方式,无漏诊率。应用PAX1基因甲基化检测方式诊断宫颈癌与CIN的受试者工作特征(ROC)曲线下面积(AUC)为0.88,P<0.001。结论:PAX1基因甲基化检验诊断CIN疾病的效果较为显著,具有良好的临床应用价值,若在临床中联合阴道镜同时进行检查,可进一步提高诊断准确性。

Objective:To investigate the clinical value of colposcopy examination and PAX1 gene methylation test in patients with cervical intraepithelial neoplasia(CIN).Methods:200 female patients who underwent cervical disease examination were selected to carry out the study.All patients underwent single colposcopy examination,single PAX1 gene methylation test and the combined examination of“colposcopy examination+PAX1 gene methylation test”.The clinical application values of these methods were observed.The cervical lesion of patients were tested by colposcopy examination and PAX1 gene methylation test,and then the two examination methods were combined to implement simultaneous test,and the results of pathological test were taken as the golden standard.The sensitivity,specificity,diagnostic coincidence rate and missed diagnosis rate of the three test methods were further compared.Results:24 cases(12%)were positive results by colposcopy examination,and 20 cases(10%)were positive results by PAX1 gene methylation test,and 36 cases(18%)were positive results by colposcopy examination and PAX1 gene methylation test.The sensitivity(100%)of combined method with colposcopy examination and PAX1 gene methylation test was significantly higher than that of other two methods,respectively,and there was no missed diagnosis rate in this combined method.The area under curve(AUC)of receiver operating characteristic(ROC)curve of PAX1 gene methylation test in diagnosing cervical cancer and CIN was 0.88,P<0.001.Conclusion:The effect of PAX1 gene methylation test is significant in diagnosing CIN,and it has favorable clinical application value.If it combines with colposcopy examination to conduct test in clinic application,the diagnostic accuracy of this method can be further improved.