Abstract:
Objective To compare the predictive value of HPV DNA and HPV E6/E7 mRNA to triage CIN2+ lesion in cervical cancer screening by meta-analysis.
Methods All literatures in the Cochrane library,PubMed,EMBASE, CNKI,Wanfang,VIP database from January 2010 to January 2018 were collected according to strigent selection standard, including cervical cancer screening with HPV DNA test and HPV E6/E7 mRNA test. Meta analysis was made by software to compare the value between HPV DNA test and HPV E6/E7 mRNA test in screening lesions of CIN2+.
Result Eight studies were included in the meta-analysis. The pooled sensitivity of HPV DNA and HPV E6/E7 mRNA for detecting CIN2+ were 0.91 (95%CI 0.88~0.93) and 0.87 (95%CI 0.84~0.90),and the pooled specificity were 0.65 (95%CI 0.62~0.67) and 0.82 (95%CI 0.80~0.83). The AUC of HPV DNA test and HPV E6/E7 mRNA tset for detecting CIN2+ were 0.875 2 and 0.883 5 respectively, the
Q* value of HPV DNA test and HPV E6/E7 mRNA test were 0.805 6 and 0.814 0 (
Z=2.34,
P<0.05). There was statistical significance between these two methods.
Conclusion Compared with HPV DNA test, HPV E6/E7 mRNA test has comparable sensitivity and similar discrimination ability, but higher specificity, which will balance the risk and benefit during cervical cancer screening better.