| Objective:System evaluation of Pap smear cytology, liquid based cytology test and human papilloma virus detection in screening of cervical cancer and precancerous lesions of CIN Ⅱ+value, which for clinical reasonable selection provides the basis of cervical cancer and precancerous lesions screening program. Methods:On the basis of Cochrane system evaluation method, computer retrieval of Cochrane Library, PubMed, SCI, EMbase, JCR, ScienceDirect, CNKI, CBM and Wanfang database was supplemented by a manual search of relevant journals, were searched from inception to2014February. Collect the randomized controlled study on Pap smear cytology, liquid based cytology and HPV detection in screening of cervical cancer and precancerous lesions. Two researchers independently selected literature, extracted data and assessed the methodological quality. Statistical analysis was performed using MetaDisc1.4statistical software. Analysis the test included if there is publication bias analysis using RevMan5software. Results:There is11RCT and a total of286846patients were included. The results of Meta analysis showed: HPV detection in the screening of cervical cancer and precancerous lesions of CIN Ⅱ+had the highest sensitivity, but its specificity was the lowest; The first line of HPV detection in the Pap smear cytology triage and first HPV detection in TCT shunt in screening of cervical cancer and precancerous lesions of CIN Ⅱ+sensitivity is relatively low, but its specificity is high; The first HPV detection in positive likelihood to TCT shunt screening showed the ratio is the highest, and the negative likelihood ratio was not elevated; The first HPV detection in the area of SROC curves with TCT shunt screening under, this method is valuable in diagnosis of cervical cancer and precancerous lesions of the highest CIN Ⅱ+. Conclusion:The combined screening methods can maximize the make up for lack of the screening methods, in order to obtain the maximum benefit of screening. |
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