P16/Ki67双染对ASCUS患者分流作用的Meta分析

A Meta-analysis ahout p16/Ki-67 immunocytochemistry for triage of women with atypical squamous cell of undetermined significance

目的系统评价P16/Ki67双染在不典型鳞状细胞(ASCUS)病变患者中筛查出宫颈上皮内病变2级及以上病变(CIN2+)的临床价值。方法计算机检索Pub Med、The Cochran Library、Embase、中国知网、维普和万方等数据库中关于P16/Ki67双染在ASCUS中分流作用的文献,采用Meta-Disc 1.4、Revman5.3等软件进行Meta分析。结果共纳入9个研究,包括ASCUS 1949例。Meta分析结果显示:P16/Ki67双染在ASCUS患者中筛查出CIN2+的汇总敏感度为0.85(95%CI为0.80~0.89),汇总特异度为0.80(95%CI为0.78~0.81),DOR合并为20.92(95%CI为14.78~29.61),AUC为0.89。结论 P16/ki67双染能有效分流ASCUS患者中的高危人群,显著降低阴道镜转诊率,避免过度诊疗。

Objective To systematically evaluate the clinical value of P16/Ki67 dual staining in the detection of cervical intraepithelial neoplasia grade 2 and above（CIN2 ＋） in ASCUS. Methods The databases of Pub Med,the Cochran Library,Embase,CNKI,VIP and Wanfang database were searched for literature about the shunt effect of P16/Ki67 double staining in ASCUS. Meta-Disc 1. 4,Revman5. 3 and other software were used for meta-analysis. Results A total of 9 studies,including 1949 people with ASCUS,were included. Meta-analysis showed that the pooled sensitivities of P16/Ki67 dual staining for CIN2 ＋ in ASCUS patients was 0. 85（95% CI 0. 80 - 0. 89）,the pooled specificity was 0. 80（95% CI 0. 78 - 0. 81）,and AUC was 0. 89. Conclusion P16/ki67 dual staining can effectively shunt highrisk patients in ASCUS patients,significantly reduce the colposcopy referral rate and avoid over diagnosis and treatment.