Yin Duo, Jiang Yan, Wang Ning, Ouyang Ling, Lu Yanming, Zhang Yao, Wei Heng, Zhang Shulan
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Tumour Biol. 2014 Sep;35(9):9247-53. doi: 10.1007/s13277-014-2214-4. Epub 2014 Jun 17.
The diagnostic accuracy of cervical cancer remains a clinical challenge, and a number of studies have used the serum hybrid capture 2 (HC2) human papillomavirus (HPV) DNA in the diagnosis of cervical cancer. The aim of the present meta-analysis was to determine the overall accuracy of HC2 HPV DNA in the diagnosis of cervical cancer. A systematic review of studies from PubMed, Embase, the Cochrane Library, Web of Science, Ovid, Chinese Biomedical Literature Database-disc, Chinese National Knowledge Infrastructure (CNKI), Technology of Chongqing (VIP), and Wan Fang database was conducted, and the data concerning the accuracy of HC2 HPV DNA in the diagnosis of cervical cancer were pooled. The methodological quality of each study was assessed by quality assessment for studies of diagnostic accuracy (QUADAS). Statistical analysis was performed by employing Meta-DiSc (version 1.4) and Stata (version 12.0) software. The overall test performance was summarized using receiver operating characteristic curves. Finally, 12 studies, including 12,492 subjects, met the inclusion criteria and then included in this present meta-analysis. The summary estimates for serum HC2 HPV DNA in the diagnosis of cervical cancer were as follows: sensitivity 0.83 (95 % confidence interval (CI) 0.81-0.85), specificity 0.71 (95 % CI 0.69-0.72), positive likelihood ratio 3.65 (95 % CI 1.77-7.54), negative likelihood ratio 0.32 (95 % CI 0.21-0.48), and diagnostic odds ratio 10.54 (95 % CI 4.95-22.46), and the area under the curve was 0.8922. Our findings suggest that HC2 HPV DNA may improve the accuracy of cervical cancer diagnosis, while the results of HC2 HPV DNA assays should be interpreted in parallel with conventional test results and other clinical findings.
宫颈癌的诊断准确性仍然是一项临床挑战，并且许多研究已将血清杂交捕获2（HC2）人乳头瘤病毒（HPV）DNA用于宫颈癌的诊断。本荟萃分析的目的是确定HC2 HPV DNA在宫颈癌诊断中的总体准确性。我们对来自PubMed、Embase、Cochrane图书馆、科学网、Ovid、中国生物医学文献数据库-disc、中国知网（CNKI）、重庆维普（VIP）和万方数据库的研究进行了系统综述，并汇总了有关HC2 HPV DNA在宫颈癌诊断中准确性的数据。每项研究的方法学质量通过诊断准确性研究的质量评估（QUADAS）进行评估。使用Meta-DiSc（1.4版）和Stata（12.0版）软件进行统计分析。使用受试者工作特征曲线总结总体测试性能。最后，12项研究（包括12492名受试者）符合纳入标准，并被纳入本荟萃分析。血清HC2 HPV DNA在宫颈癌诊断中的汇总估计如下：敏感性0.83（95%置信区间（CI）0.81-0.85），特异性0.71（95%CI 0.69-0.72），阳性似然比3.65（95%CI 1.77-7.54），阴性似然比0.32（95%CI 0.21-0.48），诊断比值比10.54（95%CI 4.95-22.46），曲线下面积为0.8922。我们的研究结果表明，HC2 HPV DNA可能提高宫颈癌诊断的准确性，而HC2 HPV DNA检测结果应与传统检测结果及其他临床发现一并解读。
