Evaluating PAX1 methylation for cervical cancer screening triage in non-16/18 hrHPV-positive women

Sep 21, 2026

Uploaded by Liam

Background in China: national cervical cancer screening uses initial high-risk human papillomavirus (hrHPV) testing, followed by cytology for hrHPV-positive cases. This study assesses whether PAX1 methylation (PAX1m) analysis can identify precancerous or cancerous lesions in cervical samples from women positive for non-16/18 hrHPV strains. Methods: 281 samples (Feb 2022–Mar 2023) compared PAX1m with conventional cytology. Results: PAX1m correlated with CIN2+ and CIN3+ risk and reduced colposcopy referrals while maintaining comparable sensitivity and NPV.

LanguageEnglish

CategoryResearch & Report

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Pages10

Reading Time25 min

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Abstract

Background

Methods

Results

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Introduction

Huang et al. BMC Cancer (2024) 24:913 BMC Cancer [https://doi.org/10.1186/s12885-024-12696-7](https://doi.org/10.1186/s12885-024-12696-7) RESEARCH Open Access Evaluating PAX1 methylation for cervical cancer screening triage in non-16/18 hrHPVpositive women Meiyuan Huang 1, Taoli Wang 1, Ming Li2, Mei Qin3, Shuang Deng 1 and Dongliang Chen 1* Abstract Background In China, the national cervical cancer screening protocol involves initial testing for high-risk human papillomavirus (hrHPV), followed by cytology for hrHPV-positive cases. This study evaluates the effectiveness of PAX1 methylation (PAX1m) analysis in identifying precancerous or cancerous lesions in cervical samples from Chinese women positive for non-16/18 hrHPV strains. Methods Between February 2022 and March 2023, 281 cervical samples from non-16/18 hrHPV-positive women underwent cytological examination and PAX1m analysis. The study assessed the statistical relationship between PAX1m levels and the presence of cervical lesions, comparing the diagnostic performance of PAX1m to conventional cytology. Results A significant association was found between PAX1 methylation levels and the risk of CIN2 +and CIN3 + lesions, with 47 instances of CIN2 +detected. Odds ratios (ORs) for moderate and high PAX1m levels were 8.86 (95% CI: 2 .24–42. 17) and 166.32 (95% CI: 47 .09-784. 97), respectively. The area under the ROC curve for PAX1min identifying CIN2 + lesions was 0.948 (95% CI: 0 .895–0. 99) . PAX1m demonstrated similar sensitivity and negative predictive value (NPV) to cytology but reduced the col poscopy referral rate from 47. 7% with cytology alone to 25. 6% with PAX1m, showing superior specificity and positive predictive value across age groups. Conclusions PAX1 methylation is a strong indicator of CIN2 +and CIN3 + risk, offering diagnostic performance comparable to cytology with the added benefit of reduced unnecessary col poscopy referrals. These findings support the use of PAX1m analysis as a reliable tool for triaging non-16/18 hrHPV-positive women in outpatient settings. Keywords Cervical cancer, hrHPV, PAX1 methylation, CIN, Col poscopy referral *Correspondence: Dongliang Chen [lycdliang@126.com](lycdliang@126.com) 1Department of Pathology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan, China 2Trauma Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan, China 3Department of Gynaecology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan, China © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it.The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit [http://](http://)[ ](http://)[creativecommons.org/l](creativecommons.org/l)icenses/by-nc-nd/4.0/. Huang et al. BMC Cancer (2024) 24:913 Introduction Cervical cancer represents a significant public health challenge worldwide, with persistent human papillomavirus (HPV) infection identified as a key etiological factor. In 2022, China witnessed 15

FAQs

What is the main screening workflow in China for cervical cancer?

High-risk human papillomavirus (hrHPV) testing is performed first, and cytology is used for hrHPV-positive cases to guide further triage.

How was the diagnostic value of PAX1 methylation (PAX1m) evaluated?

Between Feb 2022 and Mar 2023, cytology and PAX1m analysis were performed on 281 cervical samples from non-16/18 hrHPV-positive women, and performance was compared statistically.

What key outcome did PAX1m provide compared with cytology?

PAX1m showed strong association with CIN2+ and CIN3+ risk, with diagnostic performance comparable to cytology, and it reduced colposcopy referral rates across age groups.

Sep 21, 2026

Uploaded by Liam