诊断学理论与实践2025，Vol.24Issue(1)：65-71,7.DOI:10.16150/j.1671-2870.2025.01.010
基因GYPC甲基化检测在HR-HPV阳性妇女子宫颈癌筛查中的应用
Application of GYPC gene methylation detection in cervical cancer screening for HR-HPV-positive women
摘要
Abstract
Objective To investigate the diagnostic efficacy of GYPC(Glypican)gene methylation(GYPCm)in cervi-cal exfoliated cells for detecting cervical cancer and precancerous lesions among women infected with high-risk human pa-pillomavirus(HR-HPV).Methods This study enrolled a total of 187 HR-HPV-positive women who underwent histopatho-logical examination of colposcopy-guided biopsy at the hospital from October 2022 to July 2023,with a median age of 40.0 years(range:17-75 years).Cervical exfoliated cells were collected before colposcopy for cytological testing,and the remai-ning specimens were tested for GYPCm status.Using the results of histopathological examination of colposcopy-guided biopsy as the gold standard,this study analyzed the diagnostic efficacy of GYPCm for detecting cervical cancer and precan-cerous lesions and compared it with cytological test results.Results The ΔCp value of GYPCm decreased significantly with increa-sing severity of cervical lesions.At a cutoff value of 15.975,the areas under the receiver operating characteristic(ROC)curves for detecting cervical intraepithelial neoplasia grade 2 or higher(CIN2+)and grade 3 or higher(CIN3+)were 0.800(95%CI:0.733-0.867)and 0.856(95%CI:0.784-0.928),respectively.To ensure that the sensitivity of GYPCm de-tection for CIN3+was not inferior to cytological testing,the optimal cutoff value was determined to be ΔCp=15.975.The positive rate of GYPCm detection in patients with cervical squamous cell carcinoma(SCC)was 100%.For CIN3+,the diag-nostic sensitivity of GYPCm detection was comparable to that of cytological testing(86.7%vs.84.4%,P=0.782),with no sta-tistically significant difference.However,GYPCm detection demonstrated significantly higher specificity(65.5%vs.29.6%,P<0.001)and positive predictive value(44.3%vs.27.5%,P<0.001)compared with cytological testing.For CIN2+,the specificity and positive predictive value of GYPCm were significantly higher than those of cytological testing(both P<0.001).Conclusions GYPCm detection can serve as an effective triage tool for HR-HPV-positive women in cervical cancer scree-ning,offering better diagnostic efficacy compared with cytological testing.关键词
GYPC甲基化/宫颈上皮内瘤变/子宫颈癌/高危型人乳头瘤病毒Key words
GYPC methylation/Cervical intraepithelial neoplasia/Cervical cancer/High-risk human papillomavirus分类
医药卫生引用本文复制引用
罗海军,练亿香,王志敢,蒋莎莉..基因GYPC甲基化检测在HR-HPV阳性妇女子宫颈癌筛查中的应用[J].诊断学理论与实践,2025,24(1):65-71,7.基金项目
长沙市自然科学基金(kq2208440) （kq2208440）
