摘要
目的:系统评价PAX1、JAM3双基因甲基化联合诊断子宫颈高级别鳞状上皮内瘤变(HSIL)的整体诊断效能,为临床决策提供循证证据。方法:检索知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBM)、Pubmed、Embase、Web of science和Cochrane Library数据库,收集PAX1、JAM3双基因甲基化对HSIL诊断价值的研究,检索时限为建库至2024年2月。按纳入及排除标准,使用QUADAS-2评价文献质量,采用meta-disc1.4进行meta分析以评估PAX1、JAM3双基因甲基化对HSIL的诊断价值。结果:最终纳入7项诊断试验。Meta分析结果显示,PAX1、JAM3双基因甲基化诊断CIN2+合并灵敏度为0.78(95%CI:0.75~0.80),合并特异度为0.95(95%CI:0.94~0.95),合并阳性似然比(PLR)为14.610(95%CI:10.116~21.099),合并阴性似然比(NLR)为0.202(95%CI:0.150~0.273),合并曲线下面积(AUC)为0.9694,合并诊断比值比(DOR)为77.36(95%CI:43.06~138.99)。PAX1、JAM3双基因甲基化诊断CIN3+合并灵敏度为0.84(95%CI:0.80~0.87),合并特异度为0.87(95%CI:0.86~0.88),合并阳性似然比(PLR)为5.911(95%CI:4.765~7.333),合并阴性似然比(NLR)为0.172(95%CI:0.098~0.304),合并曲线下面积(AUC)为0.9251,合并诊断比值比(DOR)为34.76(95%CI:20.09~60.13)。结论:PAX1和JAM3双基因甲基化在诊断HSIL方面具有较高的敏感度和特异度,具有较高的诊断效能。
Objective:To systematically evaluate the overall diagnostic efficacy of PAX1 and JAM3 dual gene methylation in the diagnosis of cervical high-grade squamous intraepithelial neoplasia(HSIL)and to provide evidence-based evidence for clinical decision-making.Methods:CNKI,Wanfang,VIP,CBM,Pubmed,Embase,Web of Science,and Cochrane Library were searched to collect the study of PAX1 and JAM3 gene methylation in the diagnosis of HSIL from the establishment of the database to February 2024.According to the inclusion and exclusion criteria,QUADAS-2 was used to evaluate the quality of the literature,and meta-disc1.4 was used to evaluate the diagnostic value of PAX1 and JAM3 dual gene methylation in HSIL.Results:Seven diagnostic tests were included.The results of meta-analysis showed that the combined sensitivity of PAX1 and JAM3 for the diagnosis of CIN2+was 0.78(95%CI:0.75~0.80),the pooled specificity was 0.95(95%CI:0.94~0.95),the pooled positive likelihood ratio(PLR)was 14.610(95%CI:10.116~21.099),and the pooled negative likelihood ratio(NLR)was 0.202(95%CI:0.150~0.273).The pooled area under the curve(AUC)was 0.9694 and the pooled diagnostic odds ratio(DOR)was 77.36(95%CI:43.06~138.99).The combined sensitivity of CIN3+for the diagnosis of PAX1 and JAM3 was 0.84(95%CI:0.80~0.87),the pooled specificity was 0.87(95%CI:0.86~0.88),the pooled positive likelihood ratio(PLR)was 5.911(95%CI:4.765~7.333),and the pooled negative likelihood ratio(NLR)was 0.172(95%CI:0.098~0.304).The pooled area under the curve(AUC)was 0.9251 and the pooled diagnostic odds ratio(DOR)was 34.76(95%CI:20.09~60.13).Conclusions:PAX1 and JAM3 dual gene methylation has high sensitivity and specificity in the diagnosis of HSIL,and has high diagnostic efficacy.
作者
肖金芬
张旭梅
刘懿
丁尚玮
曾倩
李芹
Xiao Jinfen;Zhang Xumei;Liu Yi(Yan'an Hospital Affiliated to Kunming Medical University,Kunming 650051)
出处
《现代妇产科进展》
2025年第9期680-684,690,共6页
Progress in Obstetrics and Gynecology
关键词
子宫颈癌筛查
子宫颈上皮内瘤变
甲基化
META分析
Uterine cervical neoplasms
Cervical intraepithelial neoplasia
Methylation
Meta-analysis
