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HPV检测独立应用于宫颈癌筛查长期预测价值的Meta分析 预览 被引量:1

Long-term Predictive Values of HPV Test Using Alone in Cervical Cancer Screening: A Metal Analysis
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摘要 目的:采用Meta分析的方法比较高危型人乳头瘤病毒(HPV)检测与细胞学检测在宫颈癌筛查中的长期预测价值。方法:计算机检索Pub Med及Web of Science数据库,纳入HPV及细胞学检测方法进行宫颈癌筛查且随访时间超过3年的临床研究。应用合并累积发生率及合并比值比(OR)评估在长期随访过程中不同筛查结果人群间宫颈上皮内瘤变(CIN)Ⅱ级及以上(CINⅡ^+)、CINⅢ级及以上(CINⅢ^+)和宫颈癌发生风险的差异。结果:纳入26篇临床研究文献。HPV检测阴性的人群在随访3年内发生CINⅡ^+、CINⅢ^+及宫颈癌的风险均低于细胞学筛查阴性人群,差异有统计学意义(CINⅡ^+:OR=0.500,P〈0.001;CINⅢ^+:OR=0.377,P〈0.001;宫颈癌:OR=0.546,P〈0.001)。而HPV阴性组在随访第5年CINⅡ^+、CINⅢ^+及宫颈癌的累积发生率仍要低于细胞学阴性组随访第3年的累积发生率,虽然差异无统计学意义(CINⅡ^+:0.47%vs 0.60%;CINⅢ^+:0.15%vs 0.20%;宫颈癌:0.016%vs 0.020%),但各OR值均小于1。结论:单独采用HPV检测是一种可行的宫颈癌筛查方法,对于HPV检测结果为阴性的人群,其筛查间期相较细胞学筛查可适当延长至5年。 Objective:To further evaluate the long-term predictive value of HPV test in cervical cancer screening. Methods:To search PubMed and Web of Science databases by computer. The studies conducted HPV-based screening program and followed up for more than 3 years were included. After data extraction,the risk of cervical intraepithelial neoplasia(CIN) grade U or worse(CIN Ⅱ^+) ,CIN gradelll or worse(CINm +) ,and cervical cancer was evaluated through the pooled cumulative incidence and odds ratio (OR) values among women with different baseline test results. Results:Finally,26 cohort studies were included. Compared to cytology negative, negative for HPV test was associated with significantly lower incidence of cervical diseases within 3 years (CIN Ⅱ^+: OR =0. 500, P 〈0. 001 ; CIN Ⅲ^+: OR= 0. 377, P 〈 0. 001 ; cervical cancer: OR=0. 546, P 〈 0. 001). The 5-year pooled cumulative incidence of CIN Ⅱ^+, CIN Ⅲ^+ and cervical cancer in HPV negative women was lower than 3-year detection rates in cytology negative women(CINⅡ^+ :0.47% vs 0.60% ;GIN Ⅲ^+:0. 15% vs 0. 20% ; cervical cancer :0. 016% vs 0. 020%) ,while the OR values had no significant difference. Conclusions :We recommend that HPV test using alone can be considered as an alternative strategy for cervical cancer screening with five-year screening interval.
作者 胡诗淇 杨雨静 赵霞 HU Shiqi1 ,YANG Yujing2 ,ZHAO Xia1(1. West China Second University Hospital, Key Laboratory of Birth Defects and Related Disease of Women and Children, Ministory of Education, Sichuan University, Chengdu Sichuan 610041, Chinas2 West China Hospital, Sichuan University, Chengdu Sichuan 610041, China)
出处 《实用妇产科杂志》 CSCD 北大核心 2018年第5期371-376,共6页 Journal of Practical Obstetrics and Gynecology
基金 四川省科技计划重点研发项目(编号:2017SZ0002)
关键词 宫颈癌 人乳头瘤病毒检测 细胞学筛查 Cervical cancer Human papilloma viras test Cytology-based screening
作者简介 通讯作者:赵霞,E-mail:xia-zhao@126.com
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参考文献1

  • 1赵霞著..子宫颈癌[M].北京:人民卫生出版社,2009:137.

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