目的:本Meta分析旨在综合评价红细胞膜蛋白带4.1like3(EPB41L3)甲基化检测在宫颈癌及其癌前病变中的诊断价值。
方法:CNKI文献,万方,科克伦图书馆,PubMed,和Ovid数据库使用主题词和自由词的组合进行搜索。筛选纳入和排除标准后检索相关数据,纳入研究的质量采用QUADAS-2标准进行评价.使用适当的软件进行异质性分析和组合效应大小计算。此外,敏感性分析用于评估组合结果的稳健性,并进行荟萃回归和亚组分析以调查异质性的起源。
结果:这项荟萃分析包括六项研究,包括525名健康个体,182个宫颈上皮内瘤变1(CIN1)样本,182CIN2样品,281CIN3样品,和226CC样品。EPB41L3甲基化检测对CIN2及以上病变表现出联合敏感性,特异性,正似然比,负似然比,诊断优势比(DOR),和综合受试者工作特征曲线的曲线下面积分别为0.67、0.76、3.19、0.41、7.60和0.80;CIN3及以上病变的评价值分别为0.73、0.84、4.35、0.33、23.94和0.90。Meta回归分析显示,人群,时间,样品类型,检测方法,文献质量,和样本量不是影响CIN2及以上病变联合诊断效能的显著异质性来源(p>0.05)。亚组分析显示,在回顾性研究中,CIN2及以上病变的联合诊断价值更高,组织样本,和中国人口,DOR分别为41.03、14.59和13.70。
结论:EPB41L3甲基化在CC和癌前病变中的诊断性能相对较低。然而,它作为潜在的生物标志物值得进一步研究。将其与多基因检测相结合,人乳头瘤病毒检测,建议进行ThinPrep液基细胞学检查,以探索CC及其癌前病变的改进诊断策略。
OBJECTIVE: This meta-analysis aimed to comprehensively evaluate the diagnostic use of erythrocyte membrane protein band 4.1like3 (
EPB41L3) methylation detection in cervical cancer (CC) and its precancerous lesions.
METHODS: CNKI, Wanfang, Cochrane Library, PubMed, and Ovid databases were searched using a combination of subject headings and free words. Pertinent data were retrieved after screening for inclusion and exclusion criteria, and the quality of the included studies was evaluated using QUADAS-2 criteria. The appropriate software was used for heterogeneity analysis and combined effect size calculation. Additionally, sensitivity analysis was used to evaluate the robustness of the combined results, and meta-regression and subgroup analysis were conducted to investigate the origins of heterogeneity.
RESULTS: This meta-analysis included six studies, including 525 healthy individuals, 182 cervical intraepithelial neoplasia 1 (CIN1) samples, 182 CIN2 samples, 281 CIN3 samples, and 226 CC samples.
EPB41L3 methylation detection for CIN2 and above lesions demonstrated combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and the area under the curve of the comprehensive receiver operating characteristic curve of 0.67, 0.76, 3.19, 0.41, 7.60, and 0.80, respectively; CIN3 and above lesions demonstrated these evaluations at 0.73, 0.84, 4.35, 0.33, 23.94, and 0.90, respectively. Meta-regression analysis revealed that the population, time, sample type, detection method, literature quality, and sample size were not significant sources of heterogeneity affecting the combined diagnostic efficacy of CIN2 and above lesions (p > 0.05). Subgroup analysis revealed higher combined diagnostic values of CIN2 and above lesions in retrospective studies, tissue samples, and Chinese populations, with DORs of 41.03, 14.59, and 13.70, respectively.
CONCLUSIONS: EPB41L3 methylation demonstrated a relatively low diagnostic performance in CC and precancerous lesions. However, it merits further investigation as a potential biomarker. Integrating it with multiple gene detection, human papillomavirus testing, and ThinPrep liquid-based cytology test examination is recommended to explore improved diagnostic strategies for CC and its precancerous lesions.