目的 比较配对盒家族基因1(paired boxed gene 1,PAX1)甲基化与p16/Ki-67双染单独及联合检测在薄层液基细胞学检查(thinprep cytologic test,TCT)为意义不明的非典型鳞状细胞(atypical squamous cells of undetermined significance,ASC-US)及低级别 鳞状上皮 内病变(low-grade squamous intraepithelial lesion,LSIL)人群中的诊断效能.方法 选择郑州大学第一附属医院2021-2022年247例TCT结果为ASC-US和LSIL患者,以阴道镜下病理结果为金标准,敏感度、特异性、准确度与ROC曲线下面积(area under the subject curve,AUC)为评价指标,比较PAX1甲基化和p16/Ki-67双染单独及联合检测的检验效能.结果 PAX1甲基化与p16/Ki-67双染的阳性率随着阴道镜下病理结果的严重程度而增加,PAX1甲基化和p16/Ki-67联合检测在TCT为ASC-US人群中的敏感度为91.25%、特异度为97.72%、准确度为95.51%,优于甲基化、p16/Ki-67双染单独检测,差异有统计学意义(P<0.01).结论 PAX1甲基化和p16/Ki-67双染联合检测可以提高TCT结果为ASC-US患者的诊断效能.
Objective To compare paired boxed gene 1(PAX1)methylation and p16/Ki-67 double staining alone and in combination in thinprep cytologic test(TCT)for distinguishing atypical squamous cells of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesion(LSIL)population.Methods A total of 247 patients with TCT results of ASC-US and LSIL admitted in our hospital from January 2021 to December 2022 were enrolled in this study.Detection efficacy of PAX1 methylation and p16/Ki-67 double staining alone and in combination was evaluated with colposcopic pathologic results as the gold standard and the sensitivity,specificity,accuracy and area under the curve(AUC)as evaluation indexes.Results The positive rates of PAX1 methylation and p16/Ki-67 double staining were increased with the severity of pathological findings.Combined detection of PAX1 methylation and p16/Ki-67 assay had a sensitivity of 91.25%,specificity of 97.72%and accuracy of 95.51%in the women with TCT of ASC-US,and these values were statistically better than those of PAX1 methylation and p16/Ki-67 double staining alone(P<0.01).Conclusion The combination of PAX1 methylation and p16/Ki-67 double-staining assay can further improve the diagnostic efficacy in patients with ASC-US on TCT results.