Introduction/Background Due to bleeding, cervical atrophy, cervical type III transformation zone and other factors, resulting in the coincidence rate of pathology between colposcopy guided biopsy and conization/surgery was only 42%-57%,it may be even lower in countries with poor health care.The study aimed to evaluate the diagnostic accuracy and agreement between pathologists by performing methylated PAX1 and ZNF582 gene tests in colposcopy guided biopsy and surgical pathology.

Methodology 217 patient’s medical records and pairs of wax blocks of biopsy and conization/surgery were collected from Xiangya Hospital, Changsha, China. After DNA extraction and bisulfite conversion process, methylated PAX1 and ZNF582 genes were detection by methylated real-time PCR system before surgery. The results of methylation, cytology, high-risk human papillomavirus (HR-HPV), colposcopy, and pathology of colposcopy biopsy and surgical specimens were evaluated.

Results The mean age of cases was 42.9 years. The positivity rates for hr-HPV,PAX1(+), ZNF582(+), TCT (≥HSIL), and colposcopy (≥HSIL) were 95.4%(n=207),47.86% (n = 56), 38.46% (n = 45), 26.50% (n = 31), and 39.31% (n = 46) in the CIN2+ pathological results. The pathological results of the punch biopsy and LEEP were not statistically significant in terms of positivity rate for CIN2+ (p = 0.545). Of all the punch biopsy results, 29.03% were upgraded to higher pathological grades and 34.10% were downgraded to lower pathological grades by LEEP. PAX1 was found in 26 patients (59.09%) with the final pathology of upgraded CIN3+.

Conclusion The noninvasive methylated gene test could indicate the cervical CIN3+ misdiagnosis in punch biopsy and increase the accuracy of biopsy results.