Introduction/Background Traditional screening methods for cervical cancer, such as high-risk human papillomavirus (hrHPV) testing and cervical cytology, have limitations. There is a clinical need for more precise patient triage methods.

Methodology A total of 136 patients who underwent examination were included in this study. Among them, 122 patients had non-high-grade cervical lesions (control group) and 14 patients had high-grade lesions (study group). The variables studied included basic information (age, BMI, menopausal status), Thinprep cytologic test (TCT) results, high-risk human papillomavirus (hrHPV) status, cervical tissue pathology, vaginal microbiota results, colposcopy findings (cervical transformation zone type), and ΔCt values of JAM3 (ΔCtJ) and PAX1 (ΔCtP) gene methylation.

Results Univariate analysis revealed significant differences in ΔCt values of PAX1 and JAM3 gene methylation and TCT results between the two study groups. Correlation analysis showed a negative correlation between cervical pathology results and ΔCtP, ΔCtJ, TCT, and vaginal microbiota diversity. The conditional inference tree model showed that when ΔCtJ > 10.13, all patients had non-high-grade cervical lesions. When ΔCtP > 6.22, 97.5% of patients had non-high-grade lesions, while only 2.5% had high-grade lesions. When ΔCtJ > 8.61 and TCT showed atypical squamous cells of undetermined significance (ASC-US) or negative for intraepithelial lesions or malignancy (NILM), 99.1% of patients had non-high-grade lesions, with only one (0.9%) detecting PAX1/JAM3 high-grade lesions. When TCT indicated high-grade squamous intraepithelial lesions (HSIL), only 66.7% of patients had high-grade lesions, while 33.3% had non-high-grade lesions. However, when TCT indicated low-grade squamous intraepithelial lesions (LSIL), ASC-US, or NILM, and ΔCtP > 6.22, 97.5% of patients had non-high-grade lesions.

Conclusion The dual-gene methylation detection of JAM3/PAX1 can be independently used or combined with TCT for stratified diagnosis of high-grade/non-high-grade cervical lesions in women with HPV infection.

Disclosures No potential conflict of interest was reported by the authors.