Li Tao, Lai Yi, Yuan Jialing
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
The Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Ann Transl Med. 2022 Jul;10(14):761. doi: 10.21037/atm-22-1732.
This study sought to systematically analyze the clinical diagnostic value of tumor markers combined with ThinPrep cytologic test (TCT) and human papillomavirus (HPV) deoxyribonucleic acid (DNA) detection for cervical cancer and pre-cancerous lesions. However, there is a lot of controversy in the field of TCT + HPV-DNA. Many people have mixed opinions on the accuracy of TCT + HPV-DNA, and there is no unified opinion. Therefore, it is necessary to further confirm the significance of this combined detection method in the early diagnosis of cervical cancer by applying meta method.
The Cochrane Library, PubMed, Web of Science, Embase, Chinese Biomedical Literature Database (CBM) databases were searched to retrieve studies. To assess the methodological quality of each study and potential risk of bias, QUADAS-2 Guidelines were used to evaluate the quality of all articles that met the inclusion criteria and data extraction of the included articles were performed, and a meta-analysis was performed of the included studies using Review Manager 5.2 software.
A total of 5 studies were included in the study, and a total of 2,778 patients were included in the study, and there was no significant publication bias observed. The meta-analysis showed that there was a statistical difference in terms of the accuracy of the tumor markers combined with TCT in the detection of cervical cancer. The results were as follows: the pooled sensitivity (SEN) was 0.86 (95% CI: 0.75-0.93); the combined specificity (SPE) was 0.79 (95% CI: 0.57-0.92); the diagnostic performance of combined with thin-layer liquid-based cytology and HPV DNA detection in the diagnosis accuracy of cervical cancer by summary receiver operating characteristic (SROC) curve analysis, result showed excellent diagnostic accuracy, with a combined area under the curve (AUC) of 0.90 (95% CI: 0.87-0.92).
Tumor markers are important for the early diagnosis of cervical cancer. Combining the tumor markers with TCT and HPV DNA detection effectively improved the detection rate.
本研究旨在系统分析肿瘤标志物联合薄层液基细胞学检测（TCT）和人乳头瘤病毒（HPV）脱氧核糖核酸（DNA）检测对宫颈癌及癌前病变的临床诊断价值。然而，在TCT + HPV-DNA领域存在诸多争议。许多人对TCT + HPV-DNA的准确性看法不一，尚无统一意见。因此，有必要通过应用Meta方法进一步证实这种联合检测方法在宫颈癌早期诊断中的意义。
检索Cochrane图书馆、PubMed、Web of Science、Embase、中国生物医学文献数据库（CBM）等数据库以获取研究。为评估每项研究的方法学质量和潜在偏倚风险，使用QUADAS-2指南评估所有符合纳入标准的文章质量，并对纳入文章进行数据提取，使用Review Manager 5.2软件对纳入研究进行Meta分析。
本研究共纳入5项研究，共纳入2778例患者，未观察到明显的发表偏倚。Meta分析显示，肿瘤标志物联合TCT检测宫颈癌的准确性存在统计学差异。结果如下：合并灵敏度（SEN）为0.86（95%CI：0.75 - 0.93）；合并特异度（SPE）为0.79（95%CI：0.57 - 0.92）；通过汇总受试者工作特征（SROC）曲线分析，薄层液基细胞学联合HPV DNA检测在宫颈癌诊断准确性方面，结果显示诊断准确性良好，曲线下合并面积（AUC）为0.90（95%CI：0.87 - 0.92）。
肿瘤标志物对宫颈癌的早期诊断具有重要意义。将肿瘤标志物与TCT和HPV DNA检测相结合可有效提高检出率。
