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不同干预方式治疗宫颈高危型HPV感染有效性的贝叶斯网状Meta分析

Efficacy of Different Pharmacological Interventions for Cervical High-risk HPV Infection: Bayesian Network Meta-analysis

  • 摘要:
    目的 基于贝叶斯网状Meta分析方法比较临床常见干预方式治疗宫颈高危型HPV感染的疗效。
    方法 检索PubMed、中国生物医学文献数据库等中英文数据库收录的从建库以来至2021年7月31日临床常见干预方式治疗宫颈高危型HPV感染的随机对照试验。按照纳入和排除标准筛选文献,Cochrane系统评价策略评价纳入文献的质量,RevMan5.3和Stata16.0软件进行Meta分析。
    结果 纳入73篇RCTs,3 642例患者,涉及8种干预方式。网状Meta分析结果显示,治疗后3个月转阴率排序为PTL > Anti-HPV BPD > ALA-PDT > Nr-CWS > BFKS > CSJZS > rhIFNα-2b > FUO;治疗后6个月转阴率排序为Nr-CWS > ALA-PDT > PTL > Anti-HPV BPD > BFKS > rhIFN > FUO > CSJZS;治疗后9个月转阴率排序为PTL > ALA-PDT > BFKS > Anti-HPV BPD > rhIFNα-2b > FUO;治疗后12个月转阴率排序为Nr-CWS > ALA-PDT > Anti-HPV BPD > PTL > BFKS > rhIFNα-2b > FUO > CSJZS。
    结论 就HPV转阴率而言,Nr-CWS和PTL具有较好的疗效,是目前较为理想的方案,但仍需今后高质量研究予以证实。

     

    Abstract:
    Objective To compare the efficacy of common clinical interventions in the treatment of cervical high-risk (HR) HPV infection based on Bayesian network meta-analysis.
    Methods Randomized controlled trials (RCTs) about common clinical interventions for cervical HR-HPV infection were searched in PubMed, Web of Science, Embase, The Cochrane Library, CBM, CNKI, Wanfang Data, and VIP databases from inception to July 31, 2021 using specific inclusion and exclusion criteria. The quality of the included studies was evaluated in accordance with the Cochrane systematic review manual. Meta-analysis was performed with Stata16 and RevMan5.3 software.
    Results Seventy-three RCTs were included, involving 3642 patients and eight treatment methods. Network meta-analysis showed that in the three months after treatment, the negative conversion rate was in the order: PTL > anti-HPV BPD > ALA-PDT > Nr-CWS > BFKS > CSJZS > rhIFNα-2b > FUO. In the six months after treatment, the negative conversion rate was in the order: Nr-CWS > ALA-PDT > PTL > anti-HPV BPD > BFKS > rhIFNα-2b > FUO > CSJZS. In the nine months after treatment, the negative conversion rate was in the order: PTL > ALA-PDT > BFKS > anti-HPV BPD > rhIFNα-2b > FUO. IN the 12 months after treatment, the negative conversion rate was in the order: Nr-CWS > ALA-PDT > anti-HPV BPD > PTL > BFKS > rhIFNα-2b > FUO > CSJZS.
    Conclusion In terms of HPV negative conversion rate, Nr-CWS and PTL are more effective and currently ideal compared with the other treatments. Owing to the quality of the evidence, the above conclusions must be confirmed by future high-quality studies.

     

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