Improving diagnosis of cervical cancer
Cervical cancer is one of the most common types of cancer in women. Routinely screening is performed by cytological analysis (PapSmear) of cervical cells and by testing for HPV DNA and RNA. These methods reliably detect the presence of HPV infection but they cannot predict the likelihood of a patient developing cervical cancer. This necessitates the identification of novel biomarkers and assays that can assist in disease prognosis. With this in mind, scientists on the EU-funded PIPAVIR (Detection of persistent infections by human papillomaviruses) project developed two test systems for the clinical diagnosis of cervical pre-cancer. Both assays tested for the overexpression of high-risk HPV E7 oncoproteins, a critical and necessary step toward HPV-related cancer. One assay comprised an ELISA-based approach while the other was a rapid test. The consortium developed industrial prototypes of these two assays and evaluated them in the clinic. A major achievement was the development of a protocol compatible with the method of liquid based cytology that facilitated implementation of the ELISA test in the clinical routine. Data on the E7 rapid test indicated that further improvements were necessary prior to its clinical application. The ELISA system could simultaneously detect all E7 proteins in a single measurement and demonstrated sufficient specificity and sensitivity to detect patients with ongoing disease. Overall, the PIPAVIR assays provided a rapid, specific and sensitive means of detecting pre-cancerous lesions of the cervix in routine screening. This will overcome delays in diagnosis and facilitate prompt treatment.
Keywords
Cervical cancer, human papilloma virus, E7 oncoprotein, ELISA, liquid based cytology