FAM19A4甲基化检测在HR-HPV阳性宫颈癌及其癌前病变评估中的临床价值

Clinical value of FAM19A4 methylation detection in evaluation of HR-HPV positive patients with cervical cancer or precancerous lesions

目的探讨FAM19A4甲基化检测在高危型人乳头瘤病毒(HR-HPV)阳性宫颈癌及其癌前病变评估中的临床价值。方法连续性纳入2020年1-12月该院收治的80例宫颈癌患者(宫颈癌组)及90例宫颈癌前病变患者(癌前病变组),以同期的80例健康体检者作为对照组。采集宫颈脱落细胞,采用杂交捕获法进行人乳头瘤病毒(HPV)的筛查及基因分型;采用双探针荧光定量PCR法检测3组HR-HPV阳性者宫颈脱落细胞中FAM19A4基因甲基化表达情况并进行统计学分析。结果宫颈癌组、癌前病变组及对照组的HR-HPV阳性率分别为92.50%(74/80)、55.56%(50/90)及7.50%(6/80),差异有统计学意义(P<0.05)。宫颈癌组HR-HPV阳性者的FAM19A4基因甲基化检出率(97.30%)明显高于癌前病变组(72.00%)与对照组(16.67%),差异有统计学意义(P<0.05),癌前病变组HR-HPV阳性者的FAM19A4基因甲基化检出率明显高于对照组(P<0.05)。宫颈癌组HR-HPV阳性者的宫颈脱落细胞中,HPV16/18阳性者的FAM19A4基因甲基化检出率(100.00%)高于非HPV16/18阳性者(92.00%),差异有统计学意义(P<0.05);癌前病变组中HPV16/18阳性者的FAM19A4甲基化检出率(75.00%)高于非HPV16/18阳性者(68.18%),差异无统计学意义(P>0.05)。结论 FAM19A4基因可能是宫颈细胞癌变的特异性分子标志物,检测PFAM19A4甲基化程度可为临床防治宫颈癌提供参考。

Objective To investigate the clinical value of FAM19A4 methylation detection in the evaluation of high-risk human papillomavirus(HR-HPV)positive patients with cervical cancer or precancerous lesions.Methods Eighty patients with cervical cancer(cervical cancer group)and 90 patients with cervical precancerous lesions(precancerous lesions group)treated in this hospital from January to December 2020 were successively enrolled in the study,meanwhile 80 people who underwent the healthy physical examination were enrolled as the control group.The exfoliated cervical cells were collected.The HPV screening and genotyping were carried out by adopting the hybridization capture method.Taqman probe-based quantitative PCR was used to detect the methylation of FAM19A4 gene of the cervical exfoliated cells in the 3 groups of HR HPV positive patients,among which the differences were statistically analyzed.Results The positive rate of HR-HPV in cervical cancer group,precancerous lesion group and control group was 92.50%(74/80),55.56%(50/90)and 7.50%(6/80),respectively,and the difference was statistically significant(P<0.05).The detection rates of FAM19A4 methylation of HR-HPV positive people in cervical cancer group(97.30%)was significantly higher than those in precancerous lesions group(72.00%)and control group(16.67%),the difference was statistically significant(P<0.05),the detection rates of FAM19A4 methylation of HR-HPV positive people in precancerous lesions group was significantly higher than those in control group(P<0.05).The detection rates of FAM19A4 methylation in cervical cancer group was higher in HPV16/18 group than that in non-HPV 16/18 group(100%.00 vs.92.00%,P<0.05),the detection rates of FAM19A4 methylation in precancerous lesion group with HPV16/18 were also higher than that in non-HPV16/18 group(75.00%vs.68.18%,P>0.05).Conclusion FAM19A4 methylation might be a specific molecular marker of cervical cell carcinogenesis.The detection of FAM19A4 methylation combined with high-risk HPV test can provide reference for early screening of cervical cancer.