Study On The Diagnostic Value Of PAX1 Gene Detection In Cervical Lesions With Incompletely Visible SC

Objective:To investigate the mechanism of the disease this study evaluated the application value of Pax 1 gene detection in cervical cancer screening,especially in the detection of high-grade cervical lesions,through quantitative meta-analysis,so as to provide the basis for exploring new biomarkers for cervical cancer screening.Methods:The database of PubMed,Cochrane Library,Excerpta Medica Database(Embase),Web of Science,CNKI,WanFang and Biomedical Library(CBM)were searched by computer.The retrieval period is from the establishment of library to December 31,2020.The diagnostic research on the application of Paxl gene methylation detection in.cervical cancer screening at home and abroad is carried out through Revman5.3 and Meta-dicc1.4 Statistical analysis of data.Results:31 Chinese and English literature were included,including 6020 patients.There was no threshold effect and significant heterogeneity(I2=63.2%)among the studies of Pax1 gene methylation applied to cervical cancer screening.The heterogeneity caused by non threshold effect was statistically significant.The combination sensitivity of Paxl gene methylation model was 0.787(0.774-0.801),and the combined specificity was 0.884(0.870-0.896)The results showed that the positive likelihood ratio was 6.056(5.005-7.329),the negative likelihood ratio was 0.221(0.188-0.260),AUC=0.9180,Q index=0.8511,and the ratio of diagnosis was 32.195(23.738-43.663).The results of the subgroup analysis of the detection method,sample type and sample content showed that the heterogeneity of this study mainly came from different detection methods,among which pyrophosphate sequencing method was more sensitive to detect the methylation of Pax 1 gene than QMSP/MSP method,and the specificity and AUC were both higher.Conclusion:In conclusion,Pax1 gene detection has a good diagnostic performance in cervical cancer detection,pyrosequencing has a high application value in gene methylation detection,DNA methylation detection can better make up for the lack of existing screening methods,and can be used as an auxiliary biomarker for cervical cancer screening It was further confirmed by clinical studies in different regions.Objective:To evaluate the effectiveness of Pax1 in cervical lesions that are not completely visible in the squamous column junction(SCJ).The abnormal of thincytologic test(TCT)and human papillomavirus(HPV)were performed.The results of colposcopy suggested that SCJ was a gene test of cervical exfoliation cells in patients with incomplete visible.The clinical application value of Pax1 gene test was evaluated.Methods:TCT and HPV were tested in 21-65 year old women who had sex history and were willing to participate in cervical cancer screening in our gynecologic clinic.All patients were examined by a fixed physician after TCT≥ ascus or HR HPV positive.According to the colposcopy examination,if SCJ is not completely visible,the cervical exfoliated cells were taken and Pax1 was performed The results showed that the results showed that the accuracy of Pax1 methylation and pathology after operation and the evaluation indexes of positive rate,sensitivity,specificity,positive predictive value and negative predictive value of all kinds of lesions were calculated.Secondly,the operation characteristic curve(ROC curve)of different groups was drawn,which was usually compared with AUC under ROC curve.Results:According to the gold standard of pathological biopsy or postoperative pathology,the positive rates of Pax1 in cervicitis group,LSIL group,HSIL group and CC group were 20%(2/10),30.43%(7/23),51.28%(20/39)and 71.42%(5/7).The positive rate of Pax1 in LSIL group(cervicitis and LSIL)was 29.72%(11/37),which was significantly lower than that in HSIL+(HSIL and CC)group(54.76%(23/42)(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 54.76%,70.27%,67.65%,57.78%,1.84 and 0.22 respectively;The sensitivity and specificity of HPV in detecting HSIL+were 100.00%and 13.51%,respectively;The sensitivity and specificity of TCT in detecting HSIL+were 35.71%and 94.59%,respectively.The area under ROC curve of Pax1 methylation,HPV and TCT were 65.8%,56.8%and 65.2%,respectively.High risk HPV positive 74 cases,the positive detection rate was 93.6%,positive 71 cases of pathological examination,the positive coincidence rate was 95.9%.The positive rate of TCT was 37.9%.Pathological examination was positive in 30 cases,the positive coincidence rate was 100%.In Pax1 group,34 cases were positive,and the positive rate was 43.0%.33 cases were positive by pathological examination,and the positive coincidence rate was 97.1%.Conclusion:Compared with HPV and TCT,Pax1 has higher overall efficiency in the diagnosis of high-grade cervical lesions,which improves the diagnostic accuracy to a certain extent,and can be further promoted in clinical work.