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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Genetics
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1481626

Assessment of PAX1 and JAM3 Methylation Triage Efficacy Across HPV Genotypes and Age Groups in High-Risk HPV-Positive Women from Southern China

Provisionally accepted
Hui Liang Hui Liang 1*Yao Liu Yao Liu 2*Suyue Yin Suyue Yin 3Mengyu Jiang Mengyu Jiang 1*Qiuyan Dou Qiuyan Dou 1*Hanhan Wang Hanhan Wang 1*Jie Liu Jie Liu 1*Yibo Chen Yibo Chen 4*Pei Liu Pei Liu 3*Jing Wang Jing Wang 3Yishan Wang Yishan Wang 3Zhe Wu Zhe Wu 2*
  • 1 Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu Province, China
  • 2 Yueyang Central Hospital, Yueyang, Hunan Province, China
  • 3 Department of Medical Laboratory, Beijing Origin-Poly Bio-Tec Co., Ltd., Beijing, China
  • 4 Changsha Hospital for Maternal and Child Health Care, Changsha, Hunan Province, China

The final, formatted version of the article will be published soon.

    Objective: This study aimed to evaluate the clinical utility of PAX1/JAM3 methylation (CISCER) test in triaging high-risk human papillomavirus (hrHPV)-positive women.We enrolled women who underwent opportunistic screening at Xuzhou Maternity and Child Health Hospital and Yueyang Central Hospital gynecology outpatient clinics from December 2022 to May 2024. The effectiveness of CISCER and cytology tests in triaging hrHPV+ patients was analyzed.Results: Among the 436 study participants, 283 (64.9%) had no cervical intraepithelial neoplasia (CIN), while 53 (12.2%) had CIN1, 40 (9.2%) had CIN2, 34 (7.8%) had CIN3, and 26 (5.9%) had cervical cancers.The CISCER tests identified all cases of cervical cancer, particularly 2 hrHPV-negative adenocarcinoma cases. In 396 hrHPV+ individuals, the sensitivity of CISCER tests for detecting CIN2+ lesions was 92.6% (95% CI: 87.2-97.9%), with a specificity of 95.7% (95% CI: 93.4-98%), and an area under the receiver operating characteristic curve (AUC) of 0.941 (95% CI: 0.903-0.979), outperforming cytology tests in both HPV16/18+ and non-16/18 hrHPV+ women. Notably, CISCER demonstrated 100% (95% CI: 90-100%) sensitivity in women aged≥50 and 100% (95%CI: 93.6-100%) specificity in women aged<30. Among CIN2+ women, 37.2% (including 3 cancer) showed low-grade cytological changes that could be detected by CISCER. Meanwhile, 52% of CIN2-women exhibited cytological abnormalities but had negative CISCER results. The immediate CIN3+ risk based on positive CISCER results was 54% (95% CI: 43.8-63.9%).The PAX1/JAM3 methylation detection using cervical exfoliated cells showed superior triage performance for hrHPV-positive patients compared to traditional strategies.

    Keywords: Junctional adhesion molecule 3, Paired box gene 1, High-risk HPV positive, cervical cancer, PAX1/JAM3 methylation

    Received: 16 Aug 2024; Accepted: 12 Nov 2024.

    Copyright: © 2024 Liang, Liu, Yin, Jiang, Dou, Wang, Liu, Chen, Liu, Wang, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hui Liang, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 221009, Jiangsu Province, China
    Yao Liu, Yueyang Central Hospital, Yueyang, Hunan Province, China
    Mengyu Jiang, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 221009, Jiangsu Province, China
    Qiuyan Dou, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 221009, Jiangsu Province, China
    Hanhan Wang, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 221009, Jiangsu Province, China
    Jie Liu, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 221009, Jiangsu Province, China
    Yibo Chen, Changsha Hospital for Maternal and Child Health Care, Changsha, 410007, Hunan Province, China
    Pei Liu, Department of Medical Laboratory, Beijing Origin-Poly Bio-Tec Co., Ltd., Beijing, China
    Zhe Wu, Yueyang Central Hospital, Yueyang, Hunan Province, China

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