The role of PAX1 and JAM3 methylation in predicting the pathological upgrading of cervical intraepithelial neoplasia before conization

Objective： To explore the effect of PAX1 and JAM3 gene methylation on pathological upgrading before conization. Methods： A total of 549 patients who underwent colposcopy at our hospital were enrolled for analysis from December 2020 to April 2022. PAX1 and JAM3 gene methylation results in preoperative cervical exfoliated cells were collected. Univariate analysis and multivariate logistic regression analysis were conducted to identify the independent risk factors influencing the pathological upgrading of conization, aiming to establish a prediction model. Results: A total of 88 patients were finally included for statistical analysis according to the inclusion and exclusion criteria. Based on univariate analysis and multivariate logistic regression analysis, ∆Ct PAX1 (P=0.016, OR: 0.784, 95%CI: 0.644-0.956) and cervical canal lesions (P=0.048, OR: 3.469, 95%CI: 1.014-11.870) were identified as independent risk factors for pathological upgrading for conization. Using the above results, we established a prediction model for pathological upgrading and plotted the receiver operator characteristic curve (ROC). The area under the curve (AUC) was calculated when the Youden index was maximized with an AUC value of 0.818 (95%CI: 0.720-0.916), specificity of 94.4%, sensitivity of 60%. The cut-off value for ∆Ct PAX1 was determined as 4 .34 when maximizing the Youden index. Conclusion： PAX1 could be a promising triage marker in predicting the pathological upgrading of CIN before conization. We found that if the △Ct PAX1 cut-off value is lower than 4.34, it is highly suggestive of pathological upgrading.