Meta-analysis of PAX1/JAM3 methylation performance in high-risk HPV-positive women

Abstract

Background: DNA methylation is an emerging biomarker for cervical cancer screening. This study aimed to evaluate the diagnostic performance of paired box gene 1/junctional adhesion molecule 3 (JAM3) dual-gene methylation analysis for detecting high-grade cervical intraepithelial neoplasia and cervical cancer, and to explore its potential utility as a triage biomarker for high-risk human papillomavirus positive women. Methods: A systematic search was conducted across 5 databases, including PubMed, for studies on PAX1/JAM3 methylation testing in cervical cancer screening. Following quality assessment via the QUADAS-2 tool, statistical analyses were performed using Meta-Disc 1.4 and Stata 17 software. Results: Eight studies involving 7494 participants were included in the meta-analysis. For diagnosing cervical intraepithelial neoplasia grade 2 and above the pooled sensitivity was 0.81 (95% CI: 0.73–0.88), specificity was 0.95 (95% CI: 0.94–0.96), and the area under the curve was 0.96. For diagnosing cervical intraepithelial neoplasia grade 3 and above the pooled sensitivity was 0.85 (95% CI: 0.75–0.92), specificity was 0.88 (95% CI: 0.86–0.89), and the area under the curve was 0.90. Conclusions: PAX1/JAM3 dual-gene methylation testing demonstrates high diagnostic accuracy for detecting high-grade cervical intraepithelial neoplasia and cervical cancer, supporting its potential role as a triage biomarker in high-risk human papillomavirus positive women.