Eight-type human papillomavirus E6/E7 oncoprotein detection as a novel and promising triage strategy for managing HPV-positive women
The management of HPV-positive women becomes particularly crucial in cervical cancer screening.Here we assessed whether detection of E6 or E7 oncoproteins targeting eight most prevalent HPV types could serve as a promising triage option.Women (N =1,416) aged 50-60 from Shanxi,China underwent screening with HPV testing and liquid-based cytology (LBC),with any positive results referring to colposcopy and biopsy if necessary.Women with HPV-positive results received further tests using DNA-based genotyping,E6 or E7 oncoprotein detection targeting HPV16/18 (for short: E6 (16/18) Test) or HPV16/18/31/33/35/45/52/58 (for short: E6/E7 (8 types) Test),respectively.Among HPV-positive women,E6/E7 (8 types) oncoproteins had lower positivity (17.37%) compared to DNA-based genotyping for same eight types (58.30%) and LBC with ASC-US threshold (50.97%);HPV16 was the genotype showing the highest frequency (8.49%) for oncoprotein detection followed by HPV52 (3.47%),58 (2.32%),33 (1.54%),18 (1.16%),45 (0.77%),35 (0.39%) and 31 (0%).For detection of cervical intraepithelial neoplasia Grade 3 or higher (CIN3+),E6/E7 (8 types) Test had similar sensitivity (100.00%) and superior specificity (85.94%) as well as positive predictive value (PPV,22.22%) compared to both LBC and DNA-based genotyping (8 types);For detection of CIN2+,E6/E7 (8 types) Test was less sensitive (67.74%) but still more specific (89.47%) and risk predictive with PPV of 46.67%.Notably,E6/E7 (8 types) Test remarkably decreased the number of colposcopies needed to detect one CIN2+ and CIN3+ (2.14 and 4.50).E6/E7 oncoprotein detection showed a good trade-off between sensitivity and specificity with more efficient colposcopy referrals,which is of great importance to maximize the benefits of HPV-based screening program,especially applicable for the areas with high HPV prevalence and low-resources.
Remila Rezhake Shang-Ying Hu Shuang Zhao Xiao-Qian Xu Xue-Lian Zhao Li Zhang Yan Wang Xun Zhang Qin-Jing Pan You-Lin Qiao Fang-Hui Zhao
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Canc Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Department of Cytology, National Cancer Center/National Clinical Research Center for Cancer/Cancer H
国际会议
北京
英文
346-356
2019-03-30（万方平台首次上网日期，不代表论文的发表时间）