SOX1及PAX1基因甲基化检测在子宫颈癌筛查中的价值研究

Study on SOX1 and PAX1 gene methylation detection in cervical cancer screening

目的 探讨不同程度子宫颈病变中SOX1及PAX1基因甲基化水平,以期为子宫颈癌筛查方案提供参考依据。方法 选取滦州市人民医院2021年9~12月收治的133例高危型人乳头瘤病毒(HPV)阳性患者,应用特异性多重PCR荧光-探针法对子宫颈脱落细胞中SOX1及PAX1基因的甲基化水平进行检测,研究其与DNA倍体分析、HPV分型检测、薄层液基细胞学检测(TCT)及组织病理学结果之间的关系。结果 甲基化检测子宫颈高度病变/子宫颈癌的阳性率为88.9%,显著高于DNA倍体分析(44.4%);甲基化检测不同型别HPV感染的阳性率由高到低依次为:HPV33(50.0%)、HPV16(32.7%)、HPV58(30.8%)、HPV18(11.1%)、HPV52(10.5%);在甲基化与TCT检测结果比较中,甲基化检测对正常子宫颈组的阳性率更低(13.3%);在综合诊断性能对比中,甲基化检测相比TCT、DNA倍体分析技术显示出了更高的特异度(84.35%)、阳性预测值(47.06%)与准确度(84.96%)。结论 SOX1及PAX1基因甲基化检测可用于子宫颈癌初筛检测的辅助诊断,对子宫颈癌前病变进行精准分流,为早期筛查提供诊断依据。

Objective To investigate the methylation levels of PAX1 and SOX1 genes in different degrees of cervical le⁃sions,and provide reference for cervical cancer screening plans.Methods A total of 133 patients with positive high-risk human papilloma virus(HPV)results admitted to Luanzhou City People's Hospital from September to December 2021 were selected,and the methylation levels of PAX1 and SOX1 genes in exfoliated cervical cells were detected by spe⁃cific multiple PCR fluorescin-probe method.To study its relationship with DNA quantitative test,HPV typing test,thin⁃prep cytologic test(TCT)and histopathology results.Results The positive rate of methylation detection for high-grade cervical lesion and cervical cancer was 88.9%,which was significantly higher than that of DNA ploidy analysis(44.4%).The positive rate of methylation test was 33(50.0%)>16(32.7%)>58(30.8%)>18(11.1%)>52(10.5%).In comparison with the results of methylation and TCT,the positive rate of normal cervical tissue group(13.3%)was lower than TCT.In the comparison of diagnostic performance,methylation detection showed higher specificity(84.35%),positive predic⁃tive value(47.06%),and accuracy(84.96%)compared to the other two methods.Conclusion Methylation detection of SOX1 and PAX1 genes can be used as an auxiliary detection method for primary screening of cervical cancer,accurate⁃ly diverting precancerous lesions of cervical cancer,and providing diagnostic basis for early screening.