Pooled analysis of the performance of liquid-based cytology in population-based cervical cancer screening studies in China.
Pooled analysis of the performance of liquid-based cytology in population-based cervical cancer screening studies in China.
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DOI：
10.1002/cncy.21297
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发表时间：
2013-09
影响因子：
3.4
通讯作者：
Qiao, You-lin
中科院分区：
文献类型：
--
作者：
Pan, Qin-Jing;Hu, Shang-ying;Zhang, Xun;Ci, Pu-wa;Zhang, Wen-hua;Guo, Hui-qin;Cao, Jian;Zhao, Fang-hui;Lytwyn, Alice;Qiao, You-lin
液基细胞学(LBC)已广泛应用于宫颈癌筛查。尽管有大量的研究和系统的综述，但很少有大型研究集中在活检证实的宫颈病变上，对于其诊断的准确性仍然存在争议。我们研究的目的是评估LBC在检测活检证实的宫颈上皮内瘤变(CIN)和癌症方面的作用。我们使用中国从1999年到2008年进行的13项基于人群的、横断面的宫颈癌筛查研究的数据，对LBC进行了汇总分析。参与者(n=26782)接受了淋巴细胞和人乳头状瘤病毒检测。筛查阳性的妇女被推荐进行阴道镜检查和活检。我们分析了LBC检测经活检证实的CIN2或更严重的病变(CIN2+)以及CIN3或更严重的病变(CIN3+)的准确性。25830例宫颈鳞癌患者中，CIN2阳性率为4.1%(107/2612)，LSIL142例(15.4%)，HSIL512/784(65.3%)，鳞癌29/30(96.7%)，鳞癌4/27(14.8%)，细胞学正常0.4%(85/21454)。浸润性癌无ASC、AGC或细胞学正常切片。LBC检测CIN2+的灵敏度为81.0%，特异度为95.4%，PPV为38.3%，NPV为99.3%，准确度为94.9%。虽然HC2的敏感性高于LBC，但LBC的特异度、PPV和总体准确度均高于HC2，分别为85.2%、18.6%和85.5%。结果表明，LBC的表现可以有效地预测存在CIN2+的风险，并可能成为发展中国家宫颈癌预防的良好筛查工具。
Liquid based cytology (LBC) has been widely used for cervical cancer screening. Despite numerous studies and systematic reviews, few large studies have focused on biopsy-confirmed cervical lesions and controversy remains about its diagnostic accuracy. The aim of our study was to assess LBC for detecting biopsy-confirmed cervical intraepithelial neoplasia (CIN) and cancer. We performed a pooled analysis of LBC using data from 13 population-based, cross-sectional, cervical-cancer screening studies performed in China from 1999 to 2008. Participants (n = 26782) received LBC and HPV testing. Screen-positive women were referred for colposcopy and biopsy. We analyzed the accuracy of LBC for detecting biopsy-confirmed CIN2 or worse lesion (CIN2+) as well as CIN3 or worse lesion (CIN3+). Of 25830 women included in the analysis, CIN2+ was found in 107/2612(4.1%) with ASC, 142/923 (15.4%) with LSIL, 512/784 (65.3%) with HSIL, 29/30 (96.7%) with SCC, 4/27(14.8%) with AGC, and 0.4% (85/21454) with normal cytology results. No invasive cancers had ASC, AGC or cytological normal slides. The overall sensitivity, specificity, PPV, NPV and accuracy of LBC for detecting CIN2+ were 81.0%, 95.4%, 38.3%, 99.3 % and 94.9% respectively. Although HC2 was more sensitive than LBC, the specificity, PPV and overall accuracy of LBC were higher than those of HC2, at 85.2%, 18.6% and 85.5%, respectively. The results indicate that performance of LBC can effectively predict a risk of existing CIN2+ and may be a good screening tool for cervical cancer prevention in a developing country.
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DOI：
10.1111/j.1525-1438.2003.13611.x
发表时间：
2003-11-01
影响因子：
4.8
作者：
Belinson, JL;Qiao, YL;Fife, D
通讯作者：
Fife, D
影响因子：
3.4
作者：
Strander, Bjoern;Andersson-Elistrom, Agneta;Ryd, Walter
通讯作者：
Ryd, Walter
影响因子：
1.8
作者：
Obwegeser, JH;Brack, S
通讯作者：
Brack, S
中华人民共和国山西省的人乳头瘤病毒感染：一项基于人群的研究。
影响因子：
8.8
作者：
Dai, M;Bao, Y P;Li, N;Clifford, G M;Vaccarella, S;Snijders, P J F;Huang, R D;Sun, L X;Meijer, C J L M;Qiao, Y L;Franceschi, S
通讯作者：
Franceschi, S
影响因子：
7.2
作者：
DeSimone, Christopher P.;Day, Misty E.;Modesitt, Susan C.
通讯作者：
Modesitt, Susan C.