亚洲人乳头瘤病毒自我采样：一项系统评价
Human papillomavirus self-sampling in Asia: a systematic review.
作者信息
Ji Xuechao, Hao Menglin, Wang Yixiao, Kong Wenzhi, Pan Zangyu, Sun Qi, Miao Jinwei
机构信息
Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, Beijing, China.
Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
出版信息
Front Microbiol. 2025 Mar 14;16:1540609. doi: 10.3389/fmicb.2025.1540609. eCollection 2025.
BACKGROUND
Human papillomavirus (HPV) self-sampling may be an accurate and effective alternative sampling method to conventional cervical cancer screening methods. This systematic review compares the accuracy and acceptance of self-sampling to clinician sampling for HPV testing in Asia.
METHODS
The PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health, and Web of Science databases were searched for publications published from the establishment of the database to 2023. The risk of bias was assessed using the QUADAS-2 tool for studies included in this review. All studies evaluating the accuracy and acceptance of HPV self-sampling, and agreement of self- and clinician-collected samples in Asia were included. The accuracy of each study was demonstrated through the sensitivity and specificity in diagnosing cervical intraepithelial neoplasia or cancer, as well as the detection rate of HPV. The agreement between the two sampling methods was assessed based on the detection outcomes of HPV. Acceptance was indicated by women's preferences for HPV self-sampling.
RESULTS
Sixty-seven studies including 117,279 adult, female participants were included in this review. The type of HPV screening, other intervention components, study design, sample size, follow-up period, analysis method, numerical outcomes, results, and limitations were extracted from each study. The sensitivity and specificity of HPV self-sampling in detecting cervical intraepithelial neoplasia were higher than 80% and 70%, consistent with the results of HPV clinician sampling. The consistency between self-sampling and clinician-sampling was high in most studies, and the kappa value was more than 0.7. Women had high acceptance of self-sampling but expressed some concerns.
CONCLUSION
Self-sampling for HPV testing can significantly improve cervical cancer screening coverage, especially in areas with limited medical resources or reluctance to accept physician sampling. In most studies, the accuracy and acceptance of HPV self-sampling was comparable to clinician sampling. However, the diagnostic criteria and HPV detection methods still need to be adjusted due to the low sensitivity of HPV self-sampling in some studies in China and India. Targeted health education should be carried out to improve the acceptance of HPV self-sampling in women.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/?s=INPLASY202520107, INPLASY202520107.
背景
人乳头瘤病毒（HPV）自我采样可能是一种比传统宫颈癌筛查方法更准确有效的替代采样方法。本系统评价比较了亚洲地区HPV检测中自我采样与临床医生采样的准确性和可接受性。
方法
检索了PubMed、Cochrane图书馆、护理学与健康相关领域累积索引以及Web of Science数据库中从建库至2023年发表的文献。使用QUADAS-2工具对纳入本评价的研究进行偏倚风险评估。纳入所有评估亚洲地区HPV自我采样的准确性和可接受性以及自我采集样本与临床医生采集样本一致性的研究。每项研究的准确性通过诊断宫颈上皮内瘤变或癌症的敏感性和特异性以及HPV检测率来体现。基于HPV的检测结果评估两种采样方法之间的一致性。以女性对HPV自我采样的偏好来表示可接受性。
结果
本评价纳入了67项研究，共117279名成年女性参与者。从每项研究中提取了HPV筛查类型、其他干预成分、研究设计、样本量、随访期、分析方法、数值结果、结果及局限性。HPV自我采样检测宫颈上皮内瘤变的敏感性和特异性高于80%和70%，与HPV临床医生采样的结果一致。大多数研究中自我采样与临床医生采样之间的一致性较高，kappa值大于0.7。女性对自我采样的接受度较高，但也表达了一些担忧。
结论
HPV检测的自我采样可显著提高宫颈癌筛查覆盖率，尤其是在医疗资源有限或不愿接受医生采样的地区。在大多数研究中，HPV自我采样的准确性和可接受性与临床医生采样相当。然而，由于中国和印度的一些研究中HPV自我采样的敏感性较低，诊断标准和HPV检测方法仍需调整。应开展针对性的健康教育以提高女性对HPV自我采样的接受度。
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