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b-DNA法检测HPV mRNA在宫颈癌筛查中的系统评价:Meta分析
作者:吴方媛1  蔡云朗2 
单位:1. 东南大学 医学院, 江苏 南京 210009;
2. 东南大学附属中大医院 妇产科, 江苏 南京 210009
关键词:宫颈癌 筛查 b-DNA 第2代杂交捕获技术 Meta分析 

目的:通过Meta分析探讨b-DNA法检测HPV E6/E7 mRNA在宫颈癌筛查中的临床应用价值。方法:对PubMed、Web of Science、CNKI、万方医学网进行检索,时间区间为2011年1月至2017年12月,根据纳入和排除标准筛选论著,提取数据资料并进行质量评价,利用Metadisc软件绘制森林图、Revman 5.3软件绘制SROC曲线、STATA 12.0软件进行发表偏倚检测。结果:纳入10项研究,共2 810例。对照组为病理结果正常、良性以及CIN1人群,实验组为CIN2、CIN3以及宫颈癌患者。结果显示:所含人群中应用b-DNA和HC2诊断病理结果≥CIN2+的合并敏感度分别为82%(95%CI为80%~85%)和89%(95%CI为86%~91%),合并特异度分别为59%(95%CI为56%~61%)和41%(95%CI为38%~43%);加权SROC曲线下面积分别为0.850 4和0.770 1,差异无统计学意义(Z=1.908 1,P>0.05)。结论:b-DNA检测特异度较高,HC2检测则具有较高的敏感度,但两者对宫颈癌临床诊断的准确性无明显差异。

Objective: To evaluate the diagnostic value of b-DNA detection of HPV E6/E7 mRNA in cervical cancer screening by Meta analysis. Methods: According to inclusion and exclusion criteria, using the databases, such as Pubmed, Web of Science, China National Knowledge Infrastructure(CNKI) and WanFang Data. After data extraction and quality evaluation, the software Meta disc 1.4 and Revman 5.3 were used to draw the forest plots and the Summary Receiver Operating Characteristic(SROC) curves. The AUCs of b-DNA and HC2 detection were detected by Z test, the Egger's regression test was applied to evaluate the publication bias by Stata 12.0. Results: A total of 10 studies with 2 810 cases were included. The control group included normal pathological findings, benign disease, and the CIN1 population. The experimental group included patients with CIN2, CIN3, and cervical cancer. Meta analysis showed that contained in the crowd, the pooled sensitivity of the diagnosis of pathological results ≥CIN2+ using the b-DNA detection and the HC2 detection were 82% (95%CI:80%-85%) and 89% (95%CI:86%-91%, respectively), the pooled specificity were 59% (95%CI:56%-61%) and 41% (95%CI:38%-43%); the area under the weighted SROC curve was 0.850 4 and 0.770 1, respectively, and the difference was not statistically significant (Z=1.908 1, P>0.05). Conclusion: The b-DNA detection has a higher specificity and the HC2 detection has a higher sensitivity. However, there is no statistically significant difference between the two Methods: in the accuracy of clinical diagnosis of cervical cancer patients.


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