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| PAX1/JAM3 Methylation and HPV E6/E7 mRNA Testing for the Detection of Cervical High-Grade Lesions(CIN2+):Diagnostic Performance and Combined Application |
| Cao Jianing1, Liu Jing2, Han Lili2,* |
1. The First Affiliated Hospital of Shihezi University,Shihezi 832000,Xinjiang,CHINA; 2. Department of Gynecology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang,CHINA |
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Abstract Objective To evaluate the diagnostic value of human papilloma virus(HPV)E6/E7 mRNA testing and PAX1/JAM3 gene promoter methylation analysis for high-grade cervical intraepithelial neoplasia(CIN2+),and to assess strategies for their combined use.Methods A total of 196 women with abnormal cervical screening results were enrolled.All participants underwent testing for HPV E6/E7 mRNA and PAX1/JAM3 promoter methylation.Using cervical biopsy histopathology as the gold standard,the positive rates of both markers were analyzed across different cervical lesion grades(including viralinfection,CIN I,CIN II,CIN III,and cervical cancer).The diagnostic performance of each marker alone and in combination was evaluated.Results The positive rates of both HPV E6/E7 mRNA and PAX1/JAM3 methylation increased significantly with the severity of cervical lesions(P<0.01).Multivariate logistic regression analysis identified both as independent risk factors for high-grade cervical lesions(CIN2+),with odds ratios(ORs)of 5.90 and 5.77,respectively.PAX1/JAM3 methylation had a greater specificity for diagnosing CIN2+(82.30%)and AUC(0.671).In the combination test,a serial(sequential)test approach greatly improved the specificity,up to 92.92%(AUC=0.687),while an approach in parallel significantly increased sensitivity up to 87.95%(AUC=0.674).Conclusion The HPV E6/E7 mRNA test has a high sensitivity and can be used as the primary method of cervical cancer screening;the PAX1/JAM3 methylation test has a high specificity,suggests considerable utility in triaging primary screen positive women.Combined usage of these two markers has complementary benefits,improving detection and accurate characterization of cervix pathology.
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Received: 26 March 2026
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