p16^(INK4a)免疫细胞化学法对子宫颈癌筛查价值的Meta分析  

Meta-analysis of the value of p16^(INK4a) immunocytochemistry in cervical cancer screening

作　　者：陈素贤 谭琦 马炀斐 谷泽慧 李琪 艾浩 CHEN Suxian;TAN Qi;MA Yangfei;GU Zehui;LI Qi;AI Hao(Department of Pathology,The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China;不详)

机构地区：[1]锦州医科大学附属第三医院病理科,121000 [2]锦州医科大学附属第三医院妇产科,121000

出　　处：《中国妇产科临床杂志》2022年第2期131-134,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：辽宁省科技厅重点研发项目(2019010168-JH8/103)。

摘　　要：目的采用循证医学方法综合评价子宫颈液基薄层细胞学检查(Thinprep liquid based cytology test,TCT)与p16^(INK4a)免疫细胞化学(p16^(INK4a)immunocytochemistry,p16^(INK4a)ICC)在子宫颈癌筛查中的价值。方法检索Pubmed,Google scholar,Cochrane clinical trial,中国知网,万方医学网等数据库,纳入有关p16^(INK4a)ICC及TCT筛查子宫颈癌的文献。采用诊断准确性实验质量评价纳入文献质量,采用Stata 16.0软件进行Meta分析。结果最终纳入10篇文献,共2694例患者,TCT与p16^(INK4a)ICC筛查的合并敏感度为86%(95%CI:77%~92%)和90%(95%CI:81%~95%),合并特异度为64%(95%CI:48%~78%)和79%(95%CI:69%~86%),合并阳性似然比为2.4(95%CI:1.6~3.6)和4.2(95%CI:2.8~6.3),合并阴性似然比为0.21(95%CI:0.13~0.34)和0.13(95%CI:0.06~0.25),合并诊断比值比为11(95%CI:6~22)和33(95%CI:13~85),受试者工作特征曲线下面积(AUC)为0.85和0.91。结论子宫颈癌筛查中应用p16^(INK4a)ICC检测较TCT具有更高的敏感性和特异性,有助于提高子宫颈癌筛查的准确性,避免漏诊。Objective To use evidence-based medicine to comprehensively evaluate two methods in cervical cancer screening:Thinprepliquid based cytology test(TCT)and p16^(INK4a)Immunocytochemistry(p16^(INK4a)ICC).Methods Pubmed,Google scholar,cochrane clinical trial,China National Knowledge Network,Wanfang Medical Network and other databases were searched,and literatures related to p16^(INK4a)ICC and TCT screening for cervical cancer were included.The quality of the included literature was evaluated,and Stata16.0 software was used for Meta analysis.Results Finally,10 articles were included with a total of 2694 patients.The combined sensitivity of TCT screening and p16^(INK4a)ICC screening was 86%(95%CI:77%~92%)and 90%(95%CI:81%~95%),the combined specificity was 64%(95%CI:48%~78%)and 79%(95%CI:69%~86%),and the combined positive likelihood ratio was 2.4(95%CI:1.6~3.6)and 4.2(95%CI:2.8~6.3),the combined negative likelihood ratio was 0.21(95%CI:0.13~0.34)and 0.13(95%CI:0.06~0.25),combined diagnostic odds ratio(DOR)was 11(95%CI:6~22)and 33(95%CI:13~85),and the area under the receiver operating characteristic curve(SROC)(AUC)was 0.85 and 0.91,respectively.Conclusions The application of p16^(INK4a)ICC test used in cervical cancer screening has higher sensitivity and specificity than TCT,which helps to improve the accuracy of cervical cancer screening and avoid missed diagnosis.

关 键 词：p16^(INK4a) 子宫颈液基薄层细胞学 免疫细胞化学 子宫颈癌筛查 META分析 

分 类 号：R737.33[医药卫生—肿瘤]