Shunt Effect of ATP10a Methylation Assay in Patients with Cervical Cytological Abnormalities
- VernacularTitle:腺苷三磷酸酶磷脂转运蛋白10a甲基化检测在子宫颈细胞学异常患者中的分流作用
- Author:
Lichang CHEN
1
;
Yiman TANG
;
Sisi CHEN
;
Haihong JIN
Author Information
1. 河北北方学院研究生院,河北 张家口 075000;秦皇岛市第一医院妇科,河北秦皇岛 066000
- Publication Type:Journal Article
- Keywords:
Adenosine triphosphatase phospholipid transporter 10a;
Methylation;
Atypical squamous cell of undetermined significance;
Low-grade squamous intraepithelial lesion;
High-risk human papilloma virus;
Triage
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(8):672-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the role of adenosine triphosphatase phospholipid transporter 10a(ATP10a)methylation assay in the triage of atypical squamous cell of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesions(LSIL)in cervical cytology.Methods:188 patients with cervical exfolia-ted cells of ASC-US and LSIL were selected,and High-risk human papilloma virus(HR-HPV)typing and cervical biopsy results of the patients were collected at the same time.The cervical biopsy pathology results were used as the gold standard,and they were divided into inflammation,LSIL,high grade squamous intraepithelial lesions(HSIL)and cervical squamous cell carcinoma(SCC).Classify inflammation and LSIL as LSIL-group,HSIL and SCC as HSIL+group to compare the efficacy of ATP10a methylation and HR-HPV testing for diagnosis of HSIL+in this population(including HSIL and SCC).Results:The methylation detection value of ATP10a in the inflam-mation,LSIL,HSIL,and SCC patients were 19.035(16.478,20.823),13.446(5.890,20.674),10.336(4.733,17.336),4.223(1.713,7.754),respectively.The methylation detection value of ATP10a in the LSIL-group was 17.812(10.787,20.686),while that in the HSIL+group was 7.251(3.170,14.194).There was a statistically sig-nificant difference between the groups(Z=-5.824,P<0.001).The proportion of HR-HPV positivity in the LSIL-group was 70.9%,which was lower than that of the HSIL+group(88.2%),and the difference was statistically significant(Z=-2.887,P=0.004).The specificity,negative predictive value(NPV),and area under the receiver operating characteristic(ROC)curve(AUC)of ATP10A methylation diagnosis of HSIL+(66.0%,79.1%,and 0.747)were higher than those of HR-HPV detection(29.1%,50.7%,0.587).Sensitivity and positive predictive value(PPV)(78.8%and 65.7%)were lower than those of HR-HPV testing(88.2%and 75.0%).when using ATP10a methylation instead of HR-HPV detection for triage of cytological abnormalities(ASC-US,LSIL),the col-poscopy referral rate could be reduced to 54.3%.In the ASC-US population,the AUC(0.683)for the diagnosis of HSIL+by ATP10a methylation test was higher than that of HR-HPV test(0.599),and the difference was statisti-cally significant(P=0.028).In the LSIL population,the AUC(0.828)for the diagnosis of HSIL+by ATP10a methylation test was still higher than that of HR-HPV test(0.563),and the difference was statistically significant(P=0.005).Conclusions:ATP10a methylation levels increased with the severity of cervical lesions,and the di-agnostic efficacy of ATP10a methylation detection for the severity of cervical lesions may not be lower than HR-HPV typing.