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目的:系统评价薄层液基细胞学检查(TCT)及人类乳头状病毒(HPV)检查在子宫颈癌筛查中的应用价值。方法:检索收集2000年以来,Cochrane数据库、Pubmed、MEDLINE、Web of science、EMBASE、万方数据库、清华同方数据库、维普数据库中与TCT及HPV检测在宫颈癌筛查(癌前病变及早期宫颈癌)诊断方面的相关文献,参照Cochrane系统评价的方法对资料进行统计分析。结果:共有12篇文献纳入研究,TCT合并的敏感性0.65(95%CI,0.62～0.68),特异性0.93(95%CI,0.92～0.93),阳性预测值8.25(95%CI,5.65～12.04),阴性预测值0.27(95%CI,0.18～0.41),合并SROC曲线下面积AUC=0.889,Q值0.819。HPV合并敏感性0.69(95%CI,0.67～0.71),特异性0.91(95%CI,0.90～0.91),阳性预测值3.93(95%CI,2.99～5.18),阴性预测值0.17(95%CI,0.09～0.31),合并SROC曲线下面积AUC=0.871,Q值0.801。结论:薄层液基细胞学检查在宫颈癌筛查中具有较高的诊断准确度,与HPV联合检测可提高诊断的准确性。
OBJECTIVE: To systematically evaluate the value of TCT and HPV in the screening of cervical cancer. Methods: The data collected from the Cochrane Database, Pubmed, MEDLINE, Web of Science, EMBASE, Wanfang Database, Tsinghua Tongfang Database, VIP database and TCT and HPV testing since 2000 have been used in cervical cancer screening (precancerous lesions and early cervical cancer ) Diagnosis of the relevant literature, with reference to the Cochrane systematic review of the method of statistical analysis. RESULTS: A total of 12 articles were included in the study. The sensitivity of TCT was 0.65 (95% CI, 0.62-0.68), specificity was 0.93 (95% CI, 0.92-0.93) and the positive predictive value was 8.25 (95% CI 5.65-12.04 ), Negative predictive value of 0.27 (95% CI, 0.18 ~ 0.41), the area under the combined SROC curve AUC = 0.889, Q value of 0.819. The combined HPV sensitivity was 0.69 (95% CI, 0.67-0.71), specificity 0.91 (95% CI 0.90-0.91), positive predictive value 3.93 (95% CI 2.99-5.18) and negative predictive value 0.17 , 0.09 ~ 0.31), the area under the combined SROC curve AUC = 0.871, Q value 0.801. Conclusion: Thin-layer liquid-based cytology has high diagnostic accuracy in cervical cancer screening, and combined with HPV testing can improve the diagnostic accuracy.