Salmonella enterica ST8333 Was Isolated as Early as July 2015

Yanan Wang^1,2,#; Yue Liu³; Baoli Zhu⁴; George F. Gao^4,5; Xuebin Xu^3,#

1. International Joint Research Center of National Animal Immunology, College of Veterinary Medicine, Henan Agricultural University, Zhengzhou City, Henan Province, China.

2. Longhu Laboratory of Advanced Immunology, Zhengzhou City, Henan Province, China.

3. Division of Pathogen Testing and Analysis, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.

4. CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.

5. Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China.

^# Corresponding author: Yanan Wang, wangyanan1001@henau.edu.cn; Xuebin Xu xuxuebin@scdc.sh.cn.

Salmonella I 1,4,[5],12:i:- has become one of the most common serovars causing human infection. The ST8333 evolved from the primary clone S. I 1,4,[5],12:i:- ST34. Recent surveillance data showed that the number of infection cases caused by ST8333 is increasing, and the ST8333 strain has become increasingly severely resistant due to the acquisition of ARGs. By mining our recent sequencing data and publicly available databases (including Enterobase, NCBI, and CLSGDBv2), we confirmed that ST8333 was isolated as early as July 25, 2015. Phylogenetic analysis indicated that the endemic transmission occurred in Xinjiang since July 2015, and then spread to other regions, for example, Sichuan and Shaanxi. Notably, the location where the ST8333 strain was first discovered does not necessarily represent the location where this ST first appeared. It is uncertain whether ST8333 will replace ST34 as the primary clone causing human infections in China and worldwide in the future. These results indicated that global attention and international close genomic monitoring on this matter are needed. Therefore, we recommend strengthening genomic surveillance and timely data sharing for public health officials and the scientific community to formulate and adjust prevention and control policies.

早在2015年7月分离出肠道沙门菌ST8333

王亚楠^1,2,#；刘玥³；朱宝利⁴；高福^4,5；许学斌^3,#

1. 国家动物免疫学国际联合研究中心，动物医学院，河南农业大学，郑州市，河南省，中国；

2. 龙湖现代免疫实验室，郑州市，河南省，中国；

3. 上海市疾病预防控制中心病原生物检定所，上海，中国；

4. 中国科学院病原微生物与免疫学重点实验室，中国科学院微生物研究所，中国科学院，北京，中国；

5. 中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者: 王亚楠，wangyanan1001@henau.edu.cn；许学斌，xuxuebin@scdc.sh.cn。

肠道沙门菌1,4,[5],12:i:-已成为引起人感染最常见的沙门菌血清型之一。ST8333是由优势克隆1,4,[5],12:i:-序列型ST34演变而来。最近的监测数据显示，由ST8333引起的感染病例数量增多，由于获得了可移动耐药基因导致ST8333耐药性日益严重。通过挖掘我们的新测序数据和公共数据库（包括Enterobase、NCBI和CLSGDBv2），确认早在2015年7月25日就分离到了ST8333菌株。系统发育分析表明，从2015年7月开始在新疆发生区域性传播，然后传播到四川和陕西等地区。值得注意的是，ST8333首次被发现的地方并不一定代表该ST首次出现的地点。目前尚不确定ST8333是否会取代ST34成为中国和全球范围内引起人感染的优势克隆。这些结果表明，这一问题需要全球关注和跨国密切的基因组监测。因此，我们建议加强基因组监测和及时数据共享，为公共卫生和科学界制定和调整预防和控制政策提供依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.226

Epidemiological Characteristics and Spatiotemporal Clustering Analysis of Human Rabies — China, 2005–2024

Xi Chen¹, Jinhui Zhang¹, Shouming Lyu^2,3, Canjun Zheng⁴, Wenwu Yin⁴, Di Mu^4,#, Yanping Zhang⁴

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China;

2. China Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China;

3. Beijing Daxing District Center for Disease Control and Prevention, Beijing, China;

4. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China.

^# Corresponding author: Di Mu, mudi@chinacdc.cn.

Rabies remains a significant zoonotic disease in China. Following comprehensive control measures implemented since 2006, annual human cases declined steadily from 2008 through 2023. However, 2024 witnessed a 36.9% increase in cases compared with 2023, indicating possible changes in transmission dynamics or control effectiveness. This study analyzes the epidemiological characteristics and spatiotemporal patterns of rabies from 2005 to 2024 to inform targeted prevention strategies. We employed descriptive epidemiological methods to analyze the spatiotemporal distribution and demographic characteristics of rabies cases in China. Spatial clustering was assessed using global and local Moran's I statistics (P<0.05). Retrospective space-time scan analysis (2005–2024) was performed using SaTScan software to identify significant disease clusters. We conducted spatial frequency analysis by calculating the number of years each county reported at least one case during the study period; counties reporting cases in ≥10 years were classified as high-frequency areas. Following a peak of 3,300 cases in 2007, rabies incidence declined continuously for 16 years before resurging in 2024 (167 cases, representing a 36.9% increase compared with 2023). Cases remained geographically concentrated, with 76.0% occurring in six central and southern provincial-level administrative divisions. The majority of affected counties (74%) reported only a single case. Males (70.0%), farmers (68.6%), and individuals aged 41-70 years (53.8%) comprised the highest-risk populations. Spatial analysis revealed that High-High clusters decreased in number over time. These clusters also shifted geographically: from widespread distribution across southwestern provincial-level administrative divisions (PLADs) during 2005-2014 to concentration in central agricultural zones during 2020–2024, particularly along the border regions of Henan, Hunan, Hubei, and Anhui PLADs. We identified 352 high-frequency counties. Spatiotemporal scan statistics detected seven significant clusters during 2005–2024, all located in central and southwestern regions. Outbreaks within these clusters peaked during summer and autumn months (July–November) from 2006 to 2013, with no new clusters emerging after 2014. Our findings demonstrate that China's rabies control efforts have successfully transitioned the epidemic from widespread endemic transmission to sporadic occurrence with localized clustering. The 2024 resurgence occurred predominantly in historically endemic hotspots identified through spatial analysis. Sustaining these control achievements will require implementing precision prevention strategies specifically targeted at these persistent high-risk counties.

人感染狂犬病流行病学及时空聚集性分析 — 中国，2005–2024年

陈曦¹，张巾晖¹，吕守明^2,3，殷文武⁴，牟笛^4,#，张彦平⁴

1. 传染病溯源预警与智能决策全国重点实验室，传染病预防控制所，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 传染病溯源预警与智能决策全国重点实验室，CFEPT项目，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

3. 北京市大兴区疾病预防控制中心，北京，中国；

4. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：牟笛，mudi@chinacdc.cn。

狂犬病仍是中国一项重要的人畜共患病。自2006年实施综合防控措施以来，年报告人狂犬病病例数从2008年起持续下降至2023年。然而，2024年病例数较2023年增长36.9%，提示潜在传播风险可能出现变化。本研究通过分析2005至2024年狂犬病的流行病学特征和时空分布规律，旨在为防控策略优化提供科学依据。采用描述性流行病学方法分析中国狂犬病病例的时空分布和人群特征。空间分析包括全局和局部莫兰指数（Moran's I，p<0.05）识别空间聚集性，基于SaTScan的回顾性时空扫描分析（2005–2024年），以及通过空间频次分析界定病例报告高频县，上报病例持续10年及以上的县被归类为高频区县。所有分析均使用R软件完成，检验水准α=0.05。中国狂犬病年发病数于2007年达到峰值（3300例）后，连续16年下降，直至2024年出现回升（167例，较2023年增长36.9%）。病例仍集中在六个中部和南方省份（占76.0%）。大多数报告病例的县（74%）仅为单例病例。高危人群为男性（70.0%）、农民（68.8%）和41–70岁个体（53.8%）。空间分析显示，高高集聚区数量减少且地理分布发生转移：从广泛分布于西南各省（2005–2014年）转变为集中在中部农业区，特别是河南、湖南、湖北和安徽的交界地带（2020–2024年）。我们识别出352个高频县。时空扫描在2005–2024年间检测到7个聚集区，均位于中部和西南部地区，疫情在2006至2013年间于夏秋季（7–11月）达到高峰。2014年后未出现新的聚集区。本研究结果表明，中国的狂犬病防控已成功将疫情态势转变为以局部聚集为主的散发状态。空间分析显示，近期疫情回升集中在历史性的流行热点地区。为巩固防控成果，未来需在这些高风险县实施精准的针对性预防策略。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.227

Genomic Characterization of Human Adenovirus Type 21 Strains — 7 PLADs, China, 2023–2024

Yali Jin¹; Naiying Mao¹; Xueping Ma²; Linqing Zhao³; Liwei Sun⁴; Jikui Deng⁵; Shu Liang⁶; Hongmei Xu⁷; Xin Li⁸; Chunyu Zhu¹; Baicheng Xia¹; Aili Cui¹; Yan Zhang¹; Zhen Zhu^1,#

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Disease, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China;

2. Testing and Inspection Institute, Ningxia Hui Autonomous Region Center for Disease Control and Prevention, Yinchuan City, Ningxia Hui Autonomous Region, China;

3. Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, China;

4. Precision Medicine Research Center, Children’s Hospital of Changchun, Changchun City, Jilin Province, China;

5. Division of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen City, Guangdong Province, China;

6. Key Laboratory of Infectious Diseases of Gansu Province, Gansu Provincial Center for Disease Control and Prevention, Lanzhou City, Gansu Province, China;

7. Department of Infectious Diseases, Children's Hospital Affiliated to Chongqing Medical University, Chongqing City, China;

8. Health Supervision Institute, Shenyang Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China.

^# Corresponding author: Zhen Zhu, zhuzhen@ivdc.chinacdc.cn.

Recent sentinel surveillance has revealed a rising prevalence of human adenovirus type 21 (HAdV-21) among HAdV infections in China. This study aimed to elucidate the molecular features of currently circulating HAdV-21 strains in China. Whole-genome sequencing (WGS) was performed on 23 HAdV-21 strains isolated from acute respiratory infection cases, 56.5% involving lower respiratory tract infections, across 7 Chinese sentinel surveillance provincial-level administrative divisions (PLADs) (2023–2024). These sequences, along with 50 previously reported HAdV-21 genomes from 6 countries (1956–2019), were integrated into a WGS dataset for comprehensive phylogenetic, genetic variation, and recombination analyses. WGS categorized the HAdV-21 strains into 3 subtypes: HAdV-21a, HAdV-21b, and historical HAdV-21p (isolated in the 1950s). HAdV-21a (1956–2024, involving 5 of the 6 countries) and HAdV-21b (2005–2024, involving 3 of the 6 countries) exhibited extensive spatiotemporal distributions. Recent Chinese strains (2023–2024) belonged to HAdV-21a and HAdV-21b (HAdV-21a/b), showing extremely high genetic homology with Chinese 2019 strains (genetic distance: 0.00007) and global strains (distance: <0.00040). Phylogenetic analysis confirmed that HAdV-21a/b shared a common ancestor and maintained a highly conserved genome despite decades of circulation. Sequence variation analysis identified shared and subtype-specific mutations in these two subtypes. Recombination pattern analysis further revealed that HAdV-21a/b acquired an HAdV-3-derived fragment in the E4 region (breakpoint: nt32,843). Recombinant HAdV-21a/b subtypes have co-circulated in China in recent years with remarkable genetic conservation. Enhanced surveillance is essential to quantify associated disease burden and guide targeted prevention and control strategies.

人腺病毒21型基因组特征分析 — 7省份，中国，2023–2024年

靳亚丽¹; 毛乃颖¹; 马学平²; 赵林清³; 孙利伟⁴; 邓继岿⁵; 梁舒⁶; 许红梅⁷; 李欣⁸; 朱春羽¹; 夏百成¹; 崔爱利¹; 张燕¹; 朱贞^1,#

1. 传染病溯源预警与智能决策全国重点实验室，国家卫生健康委医学病毒和病毒病重点实验室，病毒病预防控制所，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 检验所，宁夏回族自治区疾病预防控制中心，银川市，宁夏回族自治区，中国；

3. 北京市儿童病毒病病因学研究重点实验室，首都儿科研究所，北京，中国；

4. 精准医学研究中心，长春市儿童医院，长春市，吉林省，中国；

5. 感染病科，深圳市儿童医院，深圳市，广东省，中国；

6. 甘肃省传染病预防控制重点实验室，甘肃省疾病预防控制中心，兰州市，甘肃省，中国；

7. 感染科，重庆医科大学附属儿童医院，重庆市，中国；

8. 卫生监督所，沈阳市疾病预防控制中心，沈阳市，辽宁省，中国。

^# 通讯作者: 朱贞，zhuzhen@ivdc.chinacdc.cn。

近期哨点监测数据显示，人腺病毒21型（HAdV-21）在我国HAdV感染病例中的检出率呈现上升趋势。本研究旨在阐明当前中国流行HAdV-21毒株的分子特征。对2023-2024年间从我国七个哨点监测省份的急性呼吸道感染病例（其中56.5%为下呼吸道感染）中分离到的23株HAdV-21进行全基因组测序（WGS）。结合既往报告的50个HAdV-21基因组（1956–2019年，涵盖六个国家），构建HAdV-21 WGS数据集，用于系统发育、遗传变异和重组分析。WGS系统发育分析将HAdV-21毒株划分为三个进化分支：HAdV-21a、HAdV-21b和HAdV-21p（1950s年代分离）。值得注意的是，HAdV-21a（时间跨度1956-2024年，分布于五个国家）和HAdV-21b（时间跨度2005-2024年，分布于五个国家）呈现广泛的时空分布特征。2023–2024年中国流行的HAdV-21毒株属于HAdV-21a和HAdV-21b（表示为HAdV-21a/b）亚型，这些毒株与中国既往毒株（遗传距离：0.00007）及全球流行毒株（遗传距离：<0.00040）均显示出高度遗传同源性。系统发育分析证实HAdV-21a/b具有共同祖先，且尽管数十年流行，其基因组仍保持高度保守。序列变异分析识别了这两个亚型共享的及亚型特异的突变位点。此外，基因重组分析揭示，HAdV-21a/b在E4区与HAdV-3发生了重组，重组断点位于nt32,843。近年来，重组HAdV-21a/b亚型在中国共流行，且表现出显著的遗传保守性。加强该病毒的监测对准确评估其相关疾病负担、指导制定精准防控策略具有重要意义。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.228

Detection of Dengue Virus RNA in Breast Milk Following Peripartum Infection — Guangzhou City, Guangdong Province, China, 2024

Fang Peng^1,&, Yuanjing Xu^1,2,&, Minghao Li¹, Zhixi Tan¹, Yuyan Lin¹, Jianting Chen¹, Yongliang Ou¹, Shuxian Pan^1,#.

¹ Guangzhou Liwan Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China.

² Bomi Center for Disease Control and Prevention, Nyingchi City, Xizang Autonomous Region, China.

^& Joint first authors.

^# Corresponding authors: Shuxian Pan, lwcdcyz@gz.gov.cn.

Through analysis of a dengue-infected patient presenting symptom 1 day before delivery, this study evaluated the risk of vertical dengue virus transmission through breast feeding. By assessing breastfeeding-associated risks and benefits, this study may inform breastfeeding guidelines for dengue-infected mothers. Breast milk samples were collected 10, 15, and 22 days after onset. Field epidemiological investigations and comprehensive laboratory analyses of blood and breast milk samples were conducted, followed by whole-genome viral sequencing using nanopore technology. Within 10 days of disease onset, dengue virus RNA, NS1 antigen, and IgM in breast milk were all positive (nucleic acid Ct value: 35.58), whereas IgG was negative. Dengue virus RNA, NS1 antigen, and IgG in breast milk were negative on the 15th day of onset, while IgM was negative until the 22nd day of onset. Phylogenetic tree analysis of the whole genome showed that this strain was most closely related to the Guangdong isolate (PP563845.1), with 99.90% homology. Early breastfeeding in patients with dengue fever during late gestation may pose a risk of viral transmission. Breastfeeding should be cautiously initiated 22 days post-onset only after confirming that both breast milk nucleic acid and IgM have seroconverted to a negative status.

围产期感染登革病毒的产妇母乳中检测到登革病毒 RNA — 中国，2024年

彭芳^1,&，徐媛婧^1,2,&，李明浩¹，谭志熹¹，林煜燕¹，陈建婷¹，欧永亮¹，潘淑贤^1,#

1. 广州市荔湾区疾病预防控制中心，广州，广东，中国；

2. 西藏波密县疾病预防控制中心，林芝，西藏自治区，中国。

^& 共同第一作者。

^# 通信作者：潘淑贤, lwcdcyz@gz.gov.cn。

通过分析一例分娩前1天发病出现登革热症状，且在产后乳汁中持续检出登革病毒核酸阳性的感染者，评估登革病毒经母乳喂养垂直传播的潜在风险，为制定登革热感染者的母乳喂养指导建议提供科学依据。开展现场流行病学调查，于感染者发病后第10、15和22天采集乳汁样本，将乳汁及血液样本进行实验室检测，利用纳米孔测序技术对病毒进行全基因组测序及进化树分析。该感染者发病10天内，乳汁中登革病毒核酸、NS1抗原、IgM均为阳性（核酸检测Ct值35.58），IgG为阴性，发病第15天，乳汁登革病毒核酸、NS1抗原和IgG转为阴性，IgM至发病第22天方转为阴性。全基因组进化树分析显示，该毒株与广东分离株（PP563845.1）亲缘关系最近，同源性为99.90%。本研究表明，妊娠晚期的登革热感染者若在早期进行母乳喂养可能存在病毒传播风险。建议在发病22天后，确认乳汁中登革病毒核酸及IgM为阴性，且婴幼儿无发热及皮疹表现、实验室检查排除登革病毒感染后，方可谨慎进行母乳喂养。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.229

Prospective Study on Clinical Performance of Host DNA Methylation Assay for Triage in Women Who Are HPV-Positive — 4 Provinces, China, 2018–2021

Jing Zhang^1,&, Jinxueyue Chen^2,&, Hui Feng¹, Ying Hong³, Jing Zhao⁴, Xiaohua Pan⁵, Yan Chen⁵, Jian Zhao¹, Yan Zhang^1,#

1. Department of Gynecology and Obstetrics, Peking University First Hospital, Beijing, China;

2. Peking University Health Science Center, Beijing, China;

3. Department of Gynecology and Obstetrics, Nanjing Drum Tower Hospital, Nanjing City, Jiangsu Province, China;

4. Department of Gynecology and Obstetrics, Hunan Provincial Maternal and Child Health Care Hospital; Changsha City, Hunan Province, China;

5. Department of Gynecology and Obstetrics, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.

^& Joint first authors.

^# Corresponding authors: Yan Zhang, zhangyan66@bjmu.edu.cn.

Effective detection methods to distinguish between transient human papillomavirus (HPV) infection and clinically relevant high-risk HPV (hrHPV)-induced diseases are lacking, leading to excessive referrals and overtreatment. This study evaluated the clinical performance of a host DNA six-methylation marker panel (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671) to triage Chinese women who were hrHPV-positive. This prospective multicenter study enrolled women aged 21–65 years with positive hrHPV testing. hrHPV genotyping, cytology, colposcopy, and the six-methylation marker assay were performed. High-grade cervical lesions were defined as histologically confirmed cervical intraepithelial neoplasia grade 2 (CIN2+). Forest plots were performed to assess the triage performance of the methylation assay. Of the 1,806 patients recruited from 4 hospitals in China, 1,659 were included. The methylation assay positivity rates were 7.5%, 73.9%, 88.9%, and 100% for CIN1, CIN2, CIN3, and cervical cancer, respectively. The six-methylation marker assay demonstrated sensitivities of 82.2% and 90.3% and specificities of 92.4% and 84.1% for CIN2+ and CIN3+, respectively, which were higher than those of HPV genotype testing and cytology (≥ASCUS) screening; the areas under the curve for CIN3+ detection were 0.87 (0.84–0.90), 0.68 (0.64–0.72), and 0.64 (0.60–0.69), respectively. The six-methylation marker assay showed the lowest colposcopy referral rate (24.2%) and required the fewest referrals for detection, with 1.32 and 2.39 referrals per CIN2+ and CIN3+ cases, respectively. In women aged <30 years, the six-methylation marker assay had the highest specificity for CIN2+ (95.7%) and a sensitivity and specificity for CIN3+ of 80.8% and 88.9%, respectively. It had the lowest referral rate (17.17%) and colposcopy referrals, with 1.24 and 2.43 per CIN2+ and CIN3+ cases, respectively. The host DNA six-methylation marker assay is a reliable triage tool for women who are hrHPV-positive, providing evidence supporting the application of methylation markers in China.

.

宿主DNA甲基化检测对HPV阳性女性的分流效能评价 — 四省份，中国，2018–2021年

张婧^1,&；陈金雪岳^2,&；冯慧¹；洪颖³；赵璟⁴；潘孝华⁵；陈炎⁵；赵健¹；张岩^1,#

1. 妇产科，北京大学第一医院，北京，中国；

2. 北京大学医学部，北京，中国；

3. 妇产科，南京鼓楼医院，南京市，江苏省，中国；

4. 妇产科，湖南省妇幼保健院，长沙市，湖南省，中国；

5. 妇产科，安徽医科大学第一附属医院，合肥市，安徽省，中国。

& 共同第一作者。

^# 通信作者：张岩，zhangyan66@bjmu.edu.cn。

目前临床尚缺乏有效的检测方法来区分一过性HPV感染与持续性HPV感染引起的宫颈病变，易造成过度转诊和治疗。本研究旨在评估一种宿主DNA基因甲基化六联检（ASTN1, DLX1, ITGA4, RXFP3, SOX17, ZNF671）在中国高危型HPV阳性的女性中的分流性能。本研究为前瞻性多中心研究，共招募了来自中国四家医院的1806名患者，其中1659例完成了HPV基因分型检测、细胞学检查、阴道镜活检病理检查和甲基化六联检，并纳入最终分析。采用森林图评估甲基化检测在高危HPV阳性女性中多种筛查策略下的分流性能。甲基化检测在CIN1、CIN2、CIN3和宫颈癌中的阳性率分别为7.5%、73.9%、88.9%和100%，且甲基化评分随着宫颈病变严重程度加重而升高。在CIN2和CIN3+组中，最常见的三种阳性甲基化标志物为ZNF671（65.8%，88.2%）、DLX1（43.5%，68.3%）和ASTN1（37%，61.3%）。甲基化检测对CIN2+和CIN3+的敏感性分别为82.2%和90.3%，特异性分别为92.4%和84.1%，均高于HPV基因分型检测和细胞学（≥ASCUS）筛查。上述三种方法对CIN3+检测的AUC值分别为0.87（0.84–0.90）、0.68（0.64–0.72）和0.64（0.60–0.69）。此外，在上述筛查策略中，甲基化检测相关阴道镜转诊率（24.2%）最低，宫颈病变检出需要的阴道镜次数最少，其中每检出1例CIN2+需转诊1.32次，每检出1例CIN3+需转诊2.39次。进一步对30岁以下女性的亚组分析显示，甲基化检测对CIN2+具有最高的特异性（95.7%），对CIN3+的敏感性和特异性分别可达80.8%和88.9%，且同样阴道镜转诊率最低，需要的检查次数最少。宿主DNA基因甲基化六联检是一种高危型HPV阳性女性相对可靠的分流工具，为在中国应用甲基化标志物检测提供了证据支持。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.230