Meta-Analysis of the Diagnostic Value of the Host Multigene Methylation for High-Grade Squamous Intraepithelial Lesion
Objective:To systematically evaluate the performance of host multigene methylation test in the di-agnosis of high-grade squamous intraepithelial lesion(HSIL)and provide evidence-based medical basis for clinical diagnosis.Methods:Chinese databases(CNKI,Wanfang,VIP,CBM)and English databases(Pubmed,Embase,The Cochrane Library,Web of Science)were searched for literature related to host multigene methylation testing for the diagnosis of cervical intraepithelial neoplasia,and the search time frame was from the date of database creation to January 11,2022.The quality of the literature was evaluated using QUADAS-2 according to inclusion and exclusion criteria,and the statistical analysis and mapping were performed by Meta-disc 1.4,and Stata15.0 software.Assess the diagnostic value of host polygenic methylation for cervical intraepithelial neoplasia grade 2 and above(CIN2 +)and grades 3 and above(CIN3 +).Results:Eight studies were included,involving a total of 3135 patients.The results of Meta-analysis showed that the combined sensitivity of host polygene methylation for diagnosing CIN2 + was0.80(95%CI 0.76-0.83),with a combined specificity of 0.78(95%CI 0.76-0.80).The positive likelihood ratio(PLR)was 8.01(95%CI 2.54-25.22),and the negative likelihood ratio(NLR)was 0.27(95%CI 0.13-0.54).The diagnostic odds ratio(DOR)was calculated as 37.74(95%CI 11.60-122.79),and the area under the curve(AUC)was 0.9566.For CIN3 +,the combined sensitivity was 0.70(95%CI 0.65-0.75),with a combined specificity of 0.75(95%CI 0.73-0.76).The PLR and NLR were 4.66(95%CI 2.82-7.70)and 0.37(95%CI 0.24-0.59),respectively.The DOR was 16.42(95%CI 8.20-32.88),and the AUC was 0.8937.Conclusions:The host multigene methylation test shows good sensitivity and specificity for the diagnosis of CIN2 + and CIN3 + which proves its high diagnostic efficacy,further indicating that it has a good triage effect on HISL.The test is expected to be a stable,accurate and effective screening and triage method for cervical cancer.
Cervical cancer screeningCervical Intraepithelial NeoplasiaMethylationMeta-analysis
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