DNA-EIA to detect high and low risk HPV genotypes in cervical lesions with E6/E7 primer mediated multiplex PCR

Abstract

Background - Oncogenicity of human papillomavirus (HPV) DNA in premalignant and malignant uterine cervical diseases is mainly induced by E6/E7 open reading frame (ORF). The presence of an oncogenic HPV DNA may be a diagnostic marker for the detection of cytologically negative smears. Aims - To evaluate an original polymerase chain reaction enzyme immunoassay (PCR- EIA) for the detection and typing of oncogenic and non-oncogenic HPV types. Methods - The test was an original multiplex labelled PCR-EIA for the detection and typing of oncogenic and nononcogenic HPV using three consensus sequence primers within the oncogenic E6/E7 ORF. One primer was dinitrophenyl (DNP) labelled and the DNP labelled amplimers could be further hybridised with specific biotinylated oligoprobes mixed in only two cocktails: oncogenic (16, 18, 31, 33 35, 52, and 58) and nononcogenic (6 and 11) HPV types in only two wells; then biotinylated oligoprobes were deposited in streptavidin- coated microplates. The PCR-EIA was validated on HPV plasmids (types 6, 11, 16, 18, 31, 33 35, 52, and 58) and used to evaluate cervical scrapes from 181 patients (median age 32 years) at high risk for cervical cancer. Results - HPV were detected in the cervical scrapes of 88 of 181 patients (48.6%); nine with non-oncogenic HPV (5.0%) and 79 with oncogenic HPV (43.6%) including 29 coinfections with oncogenic and nononcogenic HPV. The number of oncogenic HPV infections increased with the presence of high grade lesions: 95.8% of the cervical scrapes from patients with high grade lesions contained oncogenic HPV compared with 32.1% of the specimens from patients without any lesions detectable by colposcopy and/or by cytological examination of the cervical smears. Moreover, 60% of cervical scrapes exhibiting low grade lesions contained oncogenic HPV. Conclusions - This test is simple, specific, sensitive, safe, fast, reproducible and easy to use in routine practice. Thus it is possible to detect simultaneously on a simple cervical scrape, two kinds of HPV - oncogenic and non-oncogenic-in just two microplate wells with non-isotopic oligo-probes.