摘要
目的对基因芯片法检测人乳头瘤病毒(HPV)感染的准确性作Meta分析和系统评价,为方法的选用提供参考。方法通过检索PubMed、中国期刊全文数据库、万方数据知识服务平台、维普数据库和互联网,收集2000-2018年发表的关于使用基因芯片法检测人乳头瘤病毒感染的研究资料,并根据文献中的原始资料评价基因芯片法检测HPV感染的准确性,采用Review Manager 5.3和MetaDiSc 1.4进行Meta分析。结果共纳入文献20篇,检测样本量为7 215例。纳入文献在样本选择存在偏倚风险,其中高风险比例占75%,发表偏倚风险未知,其余5个方面的偏倚风险等级均为低风险。基因芯片法在检测门诊患者HPV感染的敏感度及其95%可信区间为0.97(0.96~0.98),特异度及其95%可信区间为0.96(0.96~0.97),诊断优势比及其95%可信区间为878.72(317.14~2434.73);检测宫颈癌患者HPV感染的敏感度及其95%可信区间为0.99(0.97~1.00),特异度及其95%可信区间为0.80(0.75~0.84),诊断优势比及其95%可信区间为166.19(9.64~2863.74)。结论基因芯片法检测HPV感染准确性高,但也存在一定的假阳性和假阴性,在实际工作中应视情况选用。
Objective To provide a reference for methods of diagnosing human papillomavirus according to a meta-analysis and systematic review of DNA chips.Methods The accuracy with which DNA chips detected human papillomavirus(HPV) was assessed based on original data in the literature,which was collected by searching PubMed,CNKI,the Wanfang Data database,VIP,and the Internet from 2000 to 2018.The quality of literature for this meta-analysis was evaluated using QUADAS-2.RevMan 5.3 and Meta-DiSc 1.4 were used to analyze the diagnostic accuracy of DNA chips and to create a forest plot and SROC curve.Results A total of 20 articles were included,and 7,215 samples were tested.There was a high risk(75%) of selection bias.The risk of reporting bias was unclear,and the risk of other forms of bias was low.DNA chips detected HPV in outpatients with a sensitivity of 0.97(95%CI: 0.96-0.98) and a specificity of 0.96(95% CI: 0.96-0.97).The odds ratio for diagnosis of HPV in outpatients was 878.72 and its 95% confidence interval was 317.14-2434.73.DNA chips detected HPV in patients with cervical cancer with a sensitivity of 0.99(95% CI: 0.97-1.00) and a specificity of 0.80(95% CI: 0.75-0.84).The odds ratio for diagnosis of HPV in those patients was 166.19,and its 95% CI was 9.64-2863.74.The area under the SROC curve was 0.9952 in outpatients and 0.9986 in patients with cervical cancer.Conclusion DNA chips detected HPV with a high level of accuracy,but they also produced a few false positives and false negatives,so they should be used in actual practice depending on circumstances.
作者
毛祥华
MAO Xiang-hua(Yunnan Institute of Parasitic Diseases,Yunnan Center for Malaria Research,Yunnan Provincial Key Laboratory of Vector-borne Disease Control and Research,Puer,Yunnan,China 665099)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第3期282-285,290,共5页
Journal of Pathogen Biology