The Study Of The Effect Of PAX1 And ZNF582 Gene Methylation On Evaluating The Degree Of Cervical Lesions And Triaging For ASC

Objective:Cervical cancer is one of the most common gynecological malignancies threatening the health of women around the world and bring serious economic burden to society and family.High-risk human papillomavirusis is an important factor for occurrence of cervical lesions and cervical cancer.Therefore,effective and accurate cervical cancer screening can identify high-risk population and take appropriate intervention and treatment measures to prevent the occurrence and progress of cervical cancer.Currently,cervical cancer screening common methods include HPV and TCT test alone or in combination.ASC includes cytological diagnosis of ASCUS and ASC-H,which is the most common diagnosis of TCT.Its treatment is also a highly controversial issue in clinical practice.The research aims to evaluate the value of PAX1 gene methylation in predicting cervical lesions and triaging for ASC.Methods : 1,758 patients were selected to accept HPV genotypingand liquid-based cytologytests voluntarily from June 2017 to January 2019 in the department of gynaecology of Shengjing hospitalaffiliated to China Medical University.Discarded TCT specimens of patients with cytological abnormality were collected for PAX1 and ZNF582 gene methylation detection.Patients with abnormal cervical cancer screening results acceptedcolposcopy and histopathological biopsy,the gold standard was pathological diagnosis.SPSS22.0 statistical software was used to analyze all results.Results: 1.HPV infection rate and TCT positive rate were on the rise with the increase of cervical lesions grade and there was a positivecorrelation between TCT results and cervical lesions grade(P<0.01,r=0.223).2.The difference of methylation positive rate and M-index median of PAX1 and ZNF582 genes was statistically significant in cervical lesions grade(all P<0.05),and difference of M-index was also significantly among the groups(all P <0.001).There were also significant statistical differences among cervical lesions grade in methylation positive rate and the M-index of combined detection of the two methods(all P<0.05).3.Spearman rank correlation analysis showed that the M-index of PAX1 and ZNF582 genes were correlated with the degree of cervical lesions(all P <0.001),correlation coefficients were 0.425 and0.545,respectively.A positive correlation between the M-index of combined detectionof the two methods and cervical lesions grade existed(P<0.001,r=0.526).4.The M-index of PAX1 and ZNF582 genes showed statistically significant differences between the chronic cervicitis and CINI group and CINII+ group(all P <0.001).ROC curves were used to evaluate the diagnostic efficacy of PAX1,ZNF582 gene methylation and combined detection of the two methods for CINII+,the AUC were0.746,0.848 and 0.831,the Cut-off value were 4.36,1.00 and 1.02,respectively.5.The difference of methylation positive rate and M-index median of PAX1 and ZNF582 genes was statistically significant in abnormal cytology(all P<0.05),and difference of M-index was also significantly among the groups(all P<0.001).There were also significant differences among abnormal cytology in the methylation positive rate abnd M-index of combined detection of the two methods(all P<0.05).6.Spearman rank correlation analysis showed that the M-index of PAX1,ZNF582 and combined detection of the two methods were correlated with the level of cytology abnormality(all P<0.001),correlation coefficients were 0.333,0.426 and 0.407,respectively.7.In ASCUS,there was no statisti CINI group and CINII+ group(P=0.238),while the difference of ZNF582 gene cally significant difference of the PAX1 gene M-index in chronic cervicitis and M-index was significant between the two groups(P=0.021),the distribution difference of M-index of combined detection of the two methods between the two groups was not significant(P=0.06).8.In ASC-H,there was no statistically significant difference of the PAX1 gene M-index in chronic cervicitis and CINI group and CINII+ group(P=0.09),while the difference of ZNF582 gene M-index was significant between the two groups(P=0.002),the distribution difference of M-index of combined detection of the two methods between the two groups was also significant(P=0.008).Conclusion : 1.PAX1 and ZNF582 gene methylation are expected to become the diagnostic indicator of cervical cancer screening,which have a certain predictive effect on the grade of cervical lesions.2.ZNF582 genemethylationhas certain clinical significance for the management of ASCUS and ASC-H population.3.Combined detection of PAX1 and ZNF582 gene methylation is of great importance in predicting the grade of cervical lesions and diagnosing high grade cervical lesions in ASC-H.