两种HPV检测方法在宫颈癌筛查中准确性比较的Meta分析  

Diagnostic accuracy of HPV E6/E7 mRNA and DNA hybrid capture 2 for cervical cancer screening:a meta-analysis

作　　者：吕江涛[1] 周德平[1] 杨君[1] 龙馨[1] 但阳[1] 

机构地区：[1]重庆市妇幼保健院宫颈病特色专科,重庆400013

出　　处：《现代妇产科进展》2017年第2期91-95,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:评价HPV E6/E7 mRNA(Aptima)和HPV DNA二代杂交捕获(HC2)检测对宫颈上皮内瘤变2级(CIN2)及以上病变(≥CIN2)的诊断价值。方法:检索Cochrane图书馆、Pubmed、Embase、中国知网和万方数据库,收集Aptima和HC2用于宫颈癌筛查的研究数据。通过meta分析合并诊断效应量,比较Aptima和HC2对≥CIN2的诊断效能。结果:共纳入13篇文献,初筛人群累计31523例(其中Aptima 15767例,HC2 15756例)。转诊人群累计13982例(其中Aptima 7004例,HC2 6978例)。初筛人群中,Aptima和HC2诊断≥CIN2的汇总敏感度分别为0.95(95%CI为0.91~0.98)和0.95(95%CI为0.90~0.97),汇总特异度分别为0.90(95%CI为0.90~0.98)和0.85(95%CI为0.84~0.86)。转诊人群中,Aptima和HC2诊断≥CIN2的汇总敏感度分别为0.93(95%CI为0.92~0.94)和0.95(95%CI为0.93~0.96),汇总特异度分别为0.47(95%CI为0.45~0.48)和0.38(95%CI为0.36~0.39)。初筛人群中,Aptima和HC2诊断≥CIN2的AUC分别是0.9672和0.8888,Q*统计量分别为0.9154和0.8194;转诊人群中,Aptima和HC2诊断≥CIN2的AUC分别是0.8389和0.8766,Q*统计量分别为0.7708和0.8070,差异均无统计学意义。结论:Aptima与HC2对≥CIN2病变的诊断敏感度和诊断效能相当,但Aptima的特异度相对更高。Objective： To evaluate and compare the diagnostic value of HPV E6 /E7mRNA（ Aptima） and HPV DNA hybrid capture（ HC2） for cervical cancer by meta-analysis.Methods： All literatures for cervical cancer screening with Aptima and HC2 were collected.Sensitivity and specificity were pooled using random-effect or fixed-effect model. Summary receiver operating characteristic curve analysis was used to evaluate the diagnostic value of Aptima and HC2.Results： Thirteen studies were included in the meta-analysis,with 31523 cases in routine screening and 13982 cases in referral population.The pooled sensitivity of Aptima and HC2 for detecting ≥CIN2 in routine screening were 0.95（ 95%CI： 0.91 - 0.98） and 0.95（ 95% CI： 0.90- 0.97）,and the pooled specificity were 0.90（ 95%CI： 0.90 - 0.98） and 0.85（ 95%CI： 0.84 - 0.86）,respectively.The Q＊ value of Aptima and HC2 were 0.9672 and 0.8888 in routine screening,and 0.7708 and 0.8070 for referral population,respectively.There was no statistical significance between the two.Conclusion： Compared with HC2,Aptima has comparable sensitivity and similar discrimination ability,but have higher specificity.

关 键 词：人乳头瘤病毒 宫颈癌筛查 META分析 

分 类 号：R711.74[医药卫生—妇产科学]