Without HPV vaccination, the cervical cancer incidence rate is still increasing in China. Screening remains the primary way to prevent cervical cancer, and there were so many methods that can be used for HPV detecting. This study was to describe the dominated HPV types in squamous cell cancer (SCC) and adenocarcinoma (ADC) in China, and to compare the clinical performance of three assays detecting HPV E6/E7 DNA, E6/E7 mRNA and E6 oncoprotein in cervical cancer.
487 women were recruited from 4 central hospitals in China, among whom 448 were diagnosed with SCC and 39 with ADC. Specimens of exfoliated cervical cells from these participants were tested by 3 assays: HPV E6/E7 DNA-based detection (BD onclarity) which could test 6 individual HPV genotypes (HPV16, 18, 31, 45, 51 and 52) and 3 groups of hrHPVs (HPV33/35, 35/39/68 and 56/59/66), HPV E6/E7 mRNA detection of 14 HR HPVtypes (APTIMA) and HPV16/18 E6 oncoprotein strip test.
SCC mainly occurred in women at 45-49 years old, and ADC was most frequently observed in women at 40-44 and 60-64 years old in China. HPV16, HPV18 and HPV33/58 were dominated in SCC, as to ADC, the dominated genotypes were HPV 16, HPV18 and HPV39/68/35. HPV 16/18 accounted for 85.4% cervical cancer in China. HPV DNA test and HPV mRNA test showed the same sensitivity in detection for cervical cancer (94.9% vs. 94.0%, P>0.05). When focused on HPV 16/18, we noticed that HPV 16/18 DNA detection found more cases than HPV 16/18 E6 oncoprotein testing (85.4% vs. 79.3%, P<0.05). And the positivity rate of HPV 16 DNA was significantly higher than that of HPV 16 oncoprotein (77.6% vs. 69.6%, P<0.05), while the positivity rate of HPV 18 DNA was the same as HPV 18 oncoprotein (11.9% vs. 13.6%, P>0.05).
HPV16 and HPV 18 were dominated in SCC and ADC in China, thus HPV16/18 vaccine would protect about 80% Chinese women from cervical cancer if the vaccination was implemented. HPV DNA and HPV mRNA testing showed almost the same sensitivity in detection of cervical cancer, both of which were better than HPV 16/18 E6 oncoprotein testing.