Application Of HPV E6 Oncoprotein Test In Cervical Cancer Screening

Objective:This study aimed to evaluate accuracy and effectiveness of HPV 16/18 E6 oncoprotein test as a primary screening test and a triage tool in cervical cancer screening. Methods:A total of 439 women visited Shanxi Province tumor hospital of department of gynaecology in May 2014 January 2015 and have engaged in sexual activities were selected as the research object.All participants are no pregnancy and cervical surgery history,have been informed consent,signed informed consent form.All subjects accepted the TCT,HPV and HPV 16/18 E6 oncoprotein test and colposcope examination.With the pathology results as the standard,the value of HPV16/18 E6 oncoprotein detection for the diagnosis of CINII+ was evaluated by comparison with the HPV DNA test. Result:1.439 cases of the research object,the positive rate of TCT,HPV DNA and HPV 16/18 E6 oncoprotein test were 80.2%,71.1%,46.5%,positive rate ot these tests is ascending with serious degree of cervical lesions.2.In the CINII+ cases,the positive rate of HPV 16/18 E6 oncoprotein was 66.9%(200/299),lower than that of HPV DNA 94.3%(236/299),the difference was statistically significant(X2=71.9,P<0.005).3. The sensitivity of HPV 16/18 E6 oncoprotein detection for diagnosis of CINII+ was 66.9%(200/299),lower than that of HPV DNA 94.3%(282/299),the difference was statistically significant(X2=71.9,P<0.005);The specificy was 97.1%(136/140),higher than that of HPV DNA 78.6%(110/140),the difference was statistically significant(X2=20.9,P<0.005);The positive predictive value was 98.0%(200/204),higher than that of HPV DNA 90.4%(282/312),the difference was statistically significant(X2=10.5,P<0.005);The negative predictive value was 57.9%(136/235),lower than that of HPV DNA 86.6%(110/127),the difference was statistically significant(X2=31.3,P<0.005).4. In the CNII+ cases, three are 256 participants at the same time express positive or negative in HPV16/18 DNA and E6 oncoprotein,the consistent rate of the two test was 85.6%(256/299), Kappa=0.76;In all subjects,the consistent rate was 87.9%(386/439),Kappa=0.83;The consistency of the two is very strong.5.In the CNII+ cases,TCT associated with E6 oncoprotein test,the sensitivity and specificity were reached 97.9% and 97.1%,the accuracy is 95.0%;TCT associated with HPV test,the sensitivity and specificity were 98.9% and 82.8%,the accuracy is 81.7%. Conclusions:E6 oncoprotein as a kind of marker that can monitor the carcinogenic activity of HPV,it can be used as a primary screening method in less developed areas that HPV DNA testing can not carry out or carry out difficult,or as a way to shunt of HPV DNA or(and) TCT positive patients,which will improve the specificity of cervical cancer screening and reasonable allocate the limited health resources.