Assessment of six markers for cervical (pre)cancer detection 51 2 CANCER DETECTION In Figure 2.4, the performance of the single markers and the bi-marker panel (at the best threshold) for the detection of cervical cancer stratified by histotype is shown. The bimarker panel detected all 40 squamous cell carcinomas and 10 other cancer histotypes. Four single markers misclassified one of the cervical cancers, involving two different cancer cases, one squamous cell carcinomas and one clear cell carcinoma. Cancer detection rate at the threshold corresponding to a predefined specificity of 70% and 80% is reported in Table 2.2. All cancers were detected by the bi-marker panel at both 70% and 80% specificity. ASCL1 + LHX8 0.0 0.0 0.2 0.2 0.4 0.4 0.6 0.6 0.8 0.8 1.0 1.0 1 − Specificity AUC: 0.882 Sensitivity Figure 2.3 Clinical performance of the bi-marker panel ASCL1/LHX8 for CIN3 detection in HPV-positive women. Cross-validated receiver operating characteristic curve and corresponding AUC. Abbreviations: AUC, area under the curve; CIN, cervical intraepithelial neoplasia SCC AC Other Methylation marker AABCDD ASCL1 LHX8 ST6GALNAC5 GHSR SST ZIC1 Bi-marker panel* negative positive Figure 2.4 DNA methylation results in HPV-positive cervical samples of women diagnosed with cervical cancer. Other histotypes: (A) adenosquamous carcinoma; (B) clear cell carcinoma; (C) mucinous adenocarcinoma, gastric type; and (D) small cell neuroendocrine carcinoma. *Bi-marker panel: ASCL1/LHX8 Abbreviations: AC, adenocarcinoma; SCC, squamous cell carcinoma
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