Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
Int J Gynecol Cancer. 2012 Jul;22(6):908-21. doi: 10.1097/IGC.0b013e318256e5e4.
The objectives of this study were to assess the accuracy of 6 common cervical screening strategies, including visual inspection with acetic acid, with a magnifying device, or with Lugol iodine (VILI), human papillomavirus testing with Hybrid Capture 2 assay, conventional Papanicolaou smear, and thin liquid-based cytology (LBC), and then to compare data obtained by the aforementioned 6 strategies.
PubMed, EMBASE, and The Cochrane Library were systematically searched for all original relevant studies about early detection of cervical cancer. A meta-analysis was performed to evaluate the accuracy of the 6 screening strategies covering sensitivity, specificity, diagnostic odds ratio, and the area under the receiver operating characteristic curve.
Fifteen articles containing 22 cross-sectional studies were finally identified. The combined estimates of sensitivity for visual inspection with acetic acid, magnified visual inspection with acetic acid, VILI, Hybrid Capture 2 assay, conventional Papanicolaou smear, and LBC were 77%, 64%, 91%, 74%, 59%, and 88%, respectively; the combined values of specificity of these screening strategies were 87%, 86%, 85%, 92%, 94%, and 88%, respectively; the diagnostic odds ratio were 22.43, 10.30, 57.44, 33.26, 22.49, and 51.56, respectively; and the area under the receiver operating characteristic curve were 0.8918, 0.7737, 0.9365, 0.9486, 0.9079, and 0.9418, respectively.
This meta-analysis suggests that LBC appeared to be promising in primary cervical cancer screening in resourced regions, and VILI might be a good choice to identify/exclude cervical cancerous and precancerous lesions in resource-constrained regions.
本研究旨在评估 6 种常见的宫颈筛查策略（醋酸肉眼检查、放大检查、卢戈碘液肉眼检查、人乳头瘤病毒检测、巴氏涂片和液基薄层细胞学检查）的准确性，并对上述 6 种策略的数据进行比较。
系统检索了 PubMed、EMBASE 和 The Cochrane Library 中关于早期宫颈癌检测的所有原始相关研究。采用荟萃分析评估了 6 种筛查策略的准确性，包括敏感度、特异度、诊断比值比和受试者工作特征曲线下面积。
最终确定了 15 篇包含 22 项横断面研究的文章。醋酸肉眼检查、放大后醋酸肉眼检查、卢戈碘液肉眼检查、Hybrid Capture 2 检测、巴氏涂片和液基薄层细胞学检查的联合敏感度分别为 77%、64%、91%、74%、59%和 88%；这些筛查策略的联合特异度分别为 87%、86%、85%、92%、94%和 88%；诊断比值比分别为 22.43、10.30、57.44、33.26、22.49 和 51.56；受试者工作特征曲线下面积分别为 0.8918、0.7737、0.9365、0.9486、0.9079 和 0.9418。
本荟萃分析表明，在资源丰富地区，液基薄层细胞学检查似乎是宫颈癌筛查的一种很有前途的方法，而在资源有限的地区，卢戈碘液肉眼检查可能是识别/排除宫颈癌前病变的良好选择。
