Clinical Application Of Methylation Detection Of Septin9 Gene In Cervical Cancer Screening In Qing Hai Province

Objective:To appraise the clinical value of Septin9 gene methylation detection in cervical cancer screening by analyzing the detection rate of Septin9 gene methylation in various histopathological results and exploring the diagnostic efficacy of Septin9 gene methylation detection in cervical cancer and precancerous lesions and the shunt efficiency in high-risk HPV and ASCUS.Methods:Female patients who underwent cervical cancer screening(high risk HPV and TCT)in Qinghai Red Cross Hospital and provincial medical association hospital of Qinghai Red Cross Hospital from March 2020 to September 2021 were selected.The screening results were consistent with those referred to colposcopy biopsy needle and then underwent Septin9 gene methylation detection and colposcopy biopsy histopathology.According to the inclusion criteria,351 cases were included.Taking the histopathological results of cervical biopsy as the gold standard,the detection rates of high risk HPV test,TCT and Septin9 gene methylation test in various histopathological results were analyzed,and whether there was a relationship between the detection rate of Septin9 methylation and the degree of cervical lesions.To explore the diagnostic efficacy of Septin9 gene methylation detection in cervical cancer and precancerous lesions and the shunt efficacy of Septin9 gene methylation detection in high-risk HPV and ASCUS compared with high-risk HPV detection,TCT,high-risk HPV detection combined with TCT.Results:1.There was no notable distinction in the basic characteristics of the subjects between the two groups(P>0.05),The two groups were comparable.There was comparability between the two groups.2.The detection rates of high-risk HPV were as follows:Normal cervix/cervicitis 50%(89/178),LSIL 91.67%(88/96),HSIL89.71%(61/68),Cervical cancer 77.78%(7/9),There was a statistical difference in the positive rate among the four groups.(χ~2=67.94,P<0.001)3.The positive rates of TCT were as follows:Normal cervix/cervicitis 24.72%(44/178),LSIL 61.46%(59/96),HSIL 73.53%(50/68),Cervical cancer 66.67%(6/9),There was a statistical difference in the positive rate among the four groups.(χ~2=64.07,P<0.001)4.The detection rates of Septin9 methylation were as follows:Normal cervix/cervicitis 21.91%(39/178),LSIL 75.00%(72/96),HSIL 94.12%(64/68),Cervical cancer 100.00%(9/9),There was a statistical difference in the positive rate among the four groups.(P<0.001)Cochran-Armitage trend test showed that there was a linear trend between the degree of cervical lesions and the detection rate of Septin9 gene methylation.(χ~2=8.27,P<0.05)5.Compared with high risk HPV detection,Septin9methylation detection has higher specificity,positive predictive value,accuracy and AUC.(P<0.05)Compared with TCT,Septin9 methylation detection has higher sensitivity,negative predictive value,accuracy and AUC.(P<0.05)Compared with high risk HPV combined with TCT,Septin9 methylation detection has higher sensitivity and negative predictive value.(P<0.05)However,the specificity and positive predictive value were lower than those of high risk HPV combined with TCT detection.(P<0.05)6.In patients with shunt non-16/18 high-risk HPV,compared with TCT,Septin9 methylation detection has higher sensitivity,negative predictive value,accuracy and AUC.(P<0.05)7.Septin9 methylation and high-risk HPV shunt cytology are ASCUS patients.Compared with high-risk HPV detection,Septin9methylation detection has higher specificity and AUC.(P<0.05)Conclusion:1.The positive detection rate of Septin9 gene methylation gradually increased with the increase of the degree of cervical lesions,and the positive detection rate of HSIL and cervical cancer was higher.2.When high-risk HPV detection and TCT screening alone,Septin9 methylation detection is more effective;when combined screening,Septin9 methylation detection and combined screening are equivalent in the diagnosis of cervical cancer and precancerous lesions.3.Septin9 gene methylation testing before referral for colposcopic biopsy can reduce the referral rate for colposcopic biopsy in some patients.4.Compared with TCT,Septin9 gene methylation detection is more effective in the diagnosis of shunt non-16/18 high-risk HPV positive patients.Compared with high-risk HPV detection,Septin9 gene methylation detection has better diagnostic efficacy in patients with shunt ASCUS.