The Discussion Of DNA Methylation In The Diagnosis Application Of Cervical Cancer

Introduction:In China,cervical cancer is the highest incidence of gynecological malignant tumor,mainly due to continuous high risk HPV infection.The vast majority of women infected with HPV virus at childbearing age are able to clear by themselves.For that,we need an effective diagnostic marker to identify different types of cervical lesions for the purpose of reducing unnecessary cervical pathology.DNA methylation can be easily detected by molecular methods.Recently,a large amount of DNA methylation regions have been proposed as new markers for the diagnosis of cervical cancer.This paper mainly discusses the application of DNA methylation in the diagnosis of the cervical cancer.Purpose:To explore the diagnosis efficacy of DNA methylation test in different cervical lesions,and to compare the sensitivity and specificity of DNA methylation test with HPV test and TCT test.Methods:Fifty-five patients who needed cervical biopsy in China-Japan Union Hospital of Ji Lin University form June 2020 to December 2021 were selected.HPV test,TCT test and DNA methylation test were performed respectively.Samples were taken by the same physician during test.According to the pathological examination results,they were divided into cervical group（7 cases）,cervical high-grade cervical squamous intraepithelial lesions（13 cases）,low-grade cervical squamous intraepithelial lesions（10 cases）.Another 25 cases had no lesion on cervical biopsy as contrast group.All patient were confirmed by cervical histopathology under colposcopy.There was no significant difference in age among the four groups（P>0.05）.Statistical analysis and description of data were performed using SPSS 26.0software.The sensitivity,specificity,Youden index（the sum of sensitivity and specificity minus 1）and AUC value（the area under ROC curve）of host gene methylation combinations were analyzed according to the pathological results of cervical biopsy.Pearsonχ~2test or Fisher exact probability method was used for data comparison between multiple groups.P<0.05 indicated that the difference was statistically significant。Results:1.There were significant difference in methylation rates between contrast group,LSIL group,HSIL group and cervical cancer group,which were 12%,20%,61.5%and100%,respectively.P value was far less then 0.05,indicating that the differences was statistically significant in different groups.2.The combined detection of 6 types of DNA methylation had the highest diagnostic efficacy in HSIL and cervical cancer group,with a Youden index of 0.6 and AUC value of 0.795,In single gene methylation detection,ZNF671 gene had the highest diagnostic efficiency,with a Youden index of 0.52 and AUC value of 0.758.3.The Youden index and AUC values of the six gene methylation test were higher than those of HPV test,which were 0.6 and 0.795 respectively.The Youden index and AUC values of the HPV test were 0.05 and 0.6,respectively.Chi-square test was performed for the sensitivity of the two detection methods,andχ~2value was 5.662,P=0.017<0.05,indicating statistically significant difference.The chi-square test for the specificity of the two detection methods showed thatχ~2value was 5.851,P=0.016<0.05,and the difference was statistically significant.4.The Youden index and AUC values of the six gene methylation test were higher than those of TCT test,which were 0.6 and 0.795 respectively.The Youden index and AUC values of the TCT test were 0.14 and 0.55,respectively.Chi-square test was conducted for the sensitivity of the two detection methods,and Fisher’s exact probability method showed that P<0.001（<0.05）,the difference was statistically significant.Fisher’s exact probability method was used to show that P<0.001（<0.05）,the difference was statistically significant.The Youden index and AUC values of 6 types of gene methylation test combined with TCT test were 0.6 and 0.795,which were the same as the Yuden index and AUC values of 6 types of gene methylation tests.Conclusion:1.There were significant differences in DNA methylation rates in different cervical lesions groups.With the aggravation of cervical lesions,the methylation rates increased significantly.The differences of methylation rates in different groups were statistically significant,indicating that DNA methylation detection could distinguish cervical lesions of different degrees.2.The combined detection of 6 types of DNA methylation had the highest diagnostic efficacy in different cervical lesions and was higher than that of any single gene.In single gene methylation detection,ZNF671 gene had the highest diagnostic efficacy.3.The detection of 6 types of DNA methylation is more effective in the diagnosis of HSIL and cervical cancer than high-risk HPV detection.4.The detection of 6 types of DNA methylation is superior to TCT detection in the diagnosis of HSIL and cervical cancer.The combination of two methods did not improve the shunt effect of 6 types of DNA methylation.