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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-03014-6

摘要内容如下：

妇女宫颈癌（CC）筛查包括人乳头瘤病毒（HPV）检测，然后对阳性病例进行细胞学分类。缺点，包括细胞学的低可重复性和对短筛查间隔的要求，增加了对替代分诊方法的需求。在此，我们使用了一种创新的分诊技术，即WID-QCIN检验，来评估28，017名年龄≥30岁的女性的人类基因DPP6、RALYL和GSX1的DNA甲基化，这些女性在2017年1月至3月期间在斯德哥尔摩参加了CC筛查。在对所有2，377份HPV阳性样本的分析中，WID-QCIN（具有预定义阈值）和HPV16和/或HPV18（HPV16/18）的组合检测出93.4%的宫颈上皮内瘤变3级和100%的侵袭性CCS。WID-QCIN/HPV16/18组合预测2级或更差的宫颈上皮内瘤变发生率为69.4%，而细胞学预测为18.2%。在6年期间，细胞学或WID-QCIN/HPV16/18分诊分别需要4.1和2.4次阴道镜检查才能发现一例2级或更严重的宫颈上皮内瘤变。这些发现支持使用WID-QCIN/HPV16/18作为HPV阳性女性的改进分诊策略。

英文原文如下：

Abstracts

Cervical cancer (CC) screening in women comprises human papillomavirus (HPV) testing followed by cytology triage of positive cases. Drawbacks, including cytology's low reproducibility and requirement for short screening intervals, raise the need for alternative triage methods. Here we used an innovative triage technique, the WID-qCIN test, to assess the DNA methylation of human genes DPP6, RALYL and GSX1 in a real-life cohort of 28,017 women aged ≥30 years who attended CC screening in Stockholm between January and March 2017. In the analysis of all 2,377 HPV-positive samples, a combination of WID-qCIN (with a predefined threshold) and HPV16 and/or HPV18 (HPV16/18) detected 93.4% of cervical intraepithelial neoplasia grade 3 and 100% of invasive CCs. The WID-qCIN/HPV16/18 combination predicted 69.4% of incident cervical intraepithelial neoplasia grade 2 or worse compared with 18.2% predicted by cytology. Cytology or WID-qCIN/HPV16/18 triage would require 4.1 and 2.4 colposcopy referrals to detect one cervical intraepithelial neoplasia grade 2 or worse, respectively, during the 6 year period. These findings support the use of WID-qCIN/HPV16/18 as an improved triage strategy for HPV-positive women.

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