摘要
Abstract
Objective:To investigate the predictive value of human papillomavirus(HPV)combined with DNA methylation markers FAM19A4,PAX1,and ZNF582 in identifying cervical CIN2+lesions in women.Methods:Retrospective collection of 627 women who under-went colposcopic cervical pathology histological examination in our hospital from September 2022 to May 2024 due to suspicious or abnormal cervical cancer screening.They were randomly divided into a training set(n=472)and a validation set(n=200)in a 7:3 ratio.Important characteristic variables were identified using Lasso regularized regression in the training set,and multifactorial logistic regression was then employed to determine the significant influencing fac-tors of cervical CIN2+lesions.A nomogram model was constructed,and the discrimination,cali-bration,and clinical applicability of the model were evaluated by plotting the receiver operating characteristic curve(ROC),calibration curve,clinical decision curve analysis(DCA),and clini-cal impact curve(CIC)of the subjects,and the model was internally validated by the validation set.Results:(1)Lasso regression showed that the remaining 12 high-risk HPV positives,HPV16/18 positives,FAM19A4,PAX1 and ZNF582 were associated with CNI2+lesions,and multifactorial logistic regression showed that HPV,FAM19A4,PAX1 and ZNF582 were the sig-nificant influences on cervical CIN2+lesions(all P<0.05),and to establish the model.(2)The area under the curve(AUC)of the model for predicting cervical CIN2+lesions in women in the training set was 0.941,with sensitivity and specificity of 0.904 and 0.847,respectively,and that of the validation set was 0.939,with sensitivity and specificity of 0.873 and 0.880,suggesting that the model was well discriminated.(3)The calibration curve showed that the pre-diction curve was more closely matched with the ideal curve.The Hosmer-Lemeshow test showed that the training set χ2=3.876,P=0.694,and the validation set χ2=3.090,P=0.686,suggesting that the model fit well.(4)The clinical decision curve and the clinical impact curve showed that the model had good clinical applicability.Conclusion:HPV,FAM19A4,PAX1,and ZNF582 are significant influencing factors for cervical CIN2+lesions,and their jointly construc-ted nomogram model is valuable for predicting women's cervical CIN2+,which can provide a guide for individualized diagnosis and treatment of patients.关键词
宫颈癌筛查/HPV/DNA甲基化/CIN2+/列线图Key words
Cervical cancer screening/HPV/DNA methylation/CIN2+/Nomogram分类
临床医学
