Accuracy of human papillomavirus tests on self-collected urine versus clinician-collected samples for the detection of cervical precancer: a systematic review and meta-analysis
조현웅, 심성률, 이재관, 홍진화,
소속 상세정보
조현웅 ( Cho Hyun-Woong )
Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
심성률 ( Shim Sung-Ryul )
Korea University College of Medicine Department of Preventive Medicine
이재관 ( Lee Jae-Kwan )
Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
홍진화 ( Hong Jin-Hwa )
Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
Abstract
Objective: The human papillomavirus (HPV) test is an effective screening tool to prevent cervical cancer. Urinary sampling for HPV detection improves the accessibility and participation of screening services and reduces the cost and burden on physicians. The clinical accuracy of urinary HPV test has yet to be determined via meta-analysis. This study assessed the clinical accuracy of these tests to detect cervical intraepithelial neoplasia (CIN) 2 or worse.
Methods: Relevant studies were identified using the PubMed, Embase, and Cochrane databases. Research eligibility was based on the clinical accuracy of HPV test on clinician-collected samples as a comparator test, and urine as an index test. The reference standard was the presence of CIN2 or worse. The pooled absolute, relative sensitivity, and specificity of the urinary HPV test versus clinician-collected samples were assessed using a bivariate model.
Results: The pooled sensitivity of urinary HPV test was significantly lower than that of clinician-collected samples (ratio=0.84, 95% confidence interval [CI]=0.78?0.91). However, some polymerase chain reaction (PCR)-based HPV test such as GP5+/6+ (relative sensitivity=0.98, 95% CI=0.91?1.05), SPF10 (relative sensitivity=0.98, 85% CI=0.88?1.08) and non GP5+/6+ PCR (relative sensitivity=1.00, 95% CI=0.88?1.14) showed similar sensitivity in both the urine and clinician-collected samples.
Conclusion: Our findings indicate that HPV test with some PCR-based assay on urine versus clinician-collected samples demonstrate similar clinical accuracy to detect CIN2 or worse. It suggests that urinary HPV test may present itself as a decent alternative screening tool for the detection of cervical pre-cancer.
키워드
Human Papillomavirus DNA Test; Urine; Cervical Intraepithelial Neoplasia; Uterine Cervical Neoplasms
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등재저널 정보
SCI(E)
MEDLINE
KCI
KoreaMed
KAMS