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.
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)
出处
《中国妇产科临床杂志》
CSCD
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)。
