Application of human papillomavirus 16/18 E6 protein detection for cervical cancer screening

Objective To evaluate the diagnostic accuracy and efficacy on cervical precancerous lesions and cervical cancer by HPV 16/18 E6 protein detection. Methods A total of 439 females with sexual activities were selected from Department of Gynaecology in Shanxi Cancer Hospital from May 2014 to January 2015, including 299 cases of cervical intraepithelial neoplasia (CIN)Ⅱ, CINⅢ or cervical cancer (the case group), and the other 140 cases (the control group). All the patients accepted the thinprep cytology test (TCT), HPV DNA and HPV 16/18 E6 oncoprotein tests and colposcope examination. Results The positive rates of the TCT, HPV DNA, HPV 16/18 E6 oncoprotein in the case group were 97.0% (290/299), 94.3% (282/299) and 66.9% (200/299), respectively, and those in the control group were 44.3% (62/140), 21.4% (30/140) and 2.9% (4/140), respectively, and there were significant differences between both groups (all P < 0.05). The sensitivity and specificity of the HPV 16/18 E6 oncoprotein test in detecting CINⅡ and above were 66.9% and 97.1%, respectively, and both of HPV DNA test were 94.3% and 78.6%, respectively; The consistent rate between HPV 16/18 E6 and HPV DNA was 71.9% (κ= 0.21). In the case group, when TCT was associated with HPV DNA test, the sensitivity, specificity and accuracy were 98.9%, 82.8% and 81.7%, respectively, and when TCT was combined with HPV 16/18 E6 oncoprotein test, those were up to 97.9%, 97.1% and 95.0%. Conclusion HPV 16/18 E6 oncoprotein test can improve the specificity of cervical cancer screening, so it may be used as a primary screening method in the less developed areas where HPV DNA test is difficult to be carried out, or as a shunt method for HPV DNA positive patients, which will allocate the limited health resources rationally. Key words: Human papillomavirus 16; Human papillomavirus 18; Uterine cervical neoplasms; Mass screening; E6 oncoprotein