摘要
目的:探讨锌指蛋白(ZNF)772甲基化及高危型人乳头瘤病毒(HR-HPV)检测在意义不明的非典型鳞状细胞(ASCUS)病人分流中的意义。方法:选取初筛ASCUS病人195例,均接受HC2-HPV-DNA检测及ZNF772基因DNA甲基化检测;比较宫颈上皮内瘤样变(CIN)Ⅱ及以上与CINⅡ以下、CINⅢ及以上及CINⅢ以下病人ZNF772基因位点甲基化水平的差异,并评估ZNF772甲基化水平及HR-HPV对ASCUS病人CINⅡ及以上、CINⅢ及以上的分流价值。结果:病理学检查显示,195例ASCUS病人中炎症80例(41.03%)、CINⅠ64例(32.82%)、CINⅡ29例(14.87%)、CINⅢ/CIS/AIS 18例(9.23%)、SCC/AC 4例(2.05%)。HR-HPV(HC2)阳性141例(72.31%)、HR-HPV(HC2)阴性54例(27.69%);CINⅡ及以上病人HR-HPV(HC2)阳性检出率高于CINⅡ以下(P<0.05);CINⅢ及以上病人HR-HPV(HC2)阳性检出率高于CINⅢ以下(P<0.05)。CINⅡ及以上、CINⅢ及以上病人ZNF772基因-420、-422位点甲基化水平分别高于CINⅡ以下、CINⅢ以下病人(P<0.05)。ZNF772基因-420、-422位点甲基化水平及HR-HPV诊断CINⅡ及以上的AUC(95%CI)分别为0.867(0.811~0.911)、0.806(0.743~0.859)、0.777(0.712~0.834),诊断CINⅢ及以上的AUC(95%CI)分别为0.891(0.838~0.931)、0.868(0.813~0.912)、0.780(0.716~0.836)。ZNF772基因-420位点甲基化水平诊断CINⅡ及以上、CINⅢ及以上的AUC面积最大。结论:相较于HC2-HPV-DNA检测,ZNF772甲基化检测更能准确地识别ASCUS中CINⅡ及以上、CINⅢ及以上病变病人,有望成为分流ASCUS的有效替代手段。
Objective:To explore the significance of zinc finger protein(ZNF)772 methylation and high-risk human papillomavirus(HR-HPV)detection in the shunt of patients with atypical squamous cell of unknown significance(ASCUS).Methods:A total of 195 initially screened ASCUS patients were selected,all of whom underwent HC2-HPV-DNA testing and ZNF772 gene DNA methylation testing.The differences in ZNF772 gene site methylation levels between patients with cervical intraepithelial neoplasia(CIN)Ⅱand above and those with CINⅡand below,CINⅢand above and CINⅢand below were compared,and the ZNF772 methylation level and HR-HPV shunt value for ASCUS patients with CINⅡand above and CINⅢand above were evaluated.Results:Pathological examination showed that among 195 ASCUS patients,there were 80 cases of inflammation(41.03%),64 cases of CINⅠ(32.82%),29 cases of CINⅡ(14.87%),18 cases of CINⅢ/CIS/AIS(9.23%),and 4 cases of SCC/AC(2.05%).One hundred and forty-one cases(72.31%)were positive for HR-HPV(HC2),and 54 cases(27.69%)were negative for HR-HPV(HC2);The positive detection rate of HR-HPV(HC2)in patients with CINⅡand above was higher than that in patients with CINⅡand below(P<0.05).The positive detection rate of HR-HPV(HC2)in patients with CINⅢand above is higher than that in patients with CINⅢand below(P<0.05).The methylation levels at the-420 and-422 loci of the ZNF772 gene in patients with CINⅡand above and CINⅢand above were higher than those in patients with CINⅡand below(P<0.05).The methylation levels at the-420 and-422 loci of the ZNF772 gene and the AUC(95%CI)for HR-HPV diagnosis of CINⅡand above were 0.867(0.811-0.911),0.806(0.743-0.859),and 0.777(0.712-0.834),respectively.The AUC(95%CI)for diagnosis of CINⅢand above were 0.891(0.838-0.931),0.868(0.813-0.912),and 0.780(0.716-0.836),respectively.The highest AUC area was detected for CINⅡand above,as well as CINⅢand above,based on the methylation level at the-420 locus of the ZNF772 gene.Conclusions:Compared with HC2-HPV-DNA detection,ZNF772 methylation detection can more accurately identify patients with CINⅡand above and CINⅢand above lesions in ASCUS,and is expected to become an effective alternative to shunt ASCUS.
作者
孙晓娟
周高英
王羽
SUN Xiaojuan;ZHOU Gaoying;WANG Yu(Department of Obstetrics and Gynecology,Kailuan General Hospital,Tangshan Hebei 063000,China)
出处
《蚌埠医学院学报》
CAS
2024年第4期497-500,505,共5页
Journal of Bengbu Medical College
