Candidate biomarkers in the cervical vaginal fluid for the (self-)diagnosis of cervical precancer

Arch Gynecol Obstet. 2018 Feb;297(2):295-311. doi: 10.1007/s00404-017-4587-2. Epub 2017 Nov 15.

Abstract

Purpose: Despite improvement in vaccines against human papilloma virus (HPV), the causative agent of cervical cancer, screening women for cervical precancer will remain indispensable in the coming 30-40 years. A simple test that could be performed at home or at a doctor's practice and that informs the woman whether she is at risk would significantly help make a broader group of patients who aware that they need medical treatment. Cervical vaginal fluid (CVF) is a body fluid that is very well suited for such a test.

Methods: Narrative review of cervical (pre)cancer candidate biomarkers from cervicovaginal fluid, is based on a detailed review of the literature. We will also discuss the possibilities that these biomarkers create for the development of a self-test or point-of-care test for cervical (pre)cancer.

Results: Several DNA, DNA methylation, miRNA, and protein biomarkers were identified in the cervical vaginal fluid; however, not all of these biomarkers are suited for development of a simple diagnostic assay.

Conclusions: Proteins, especially alpha-actinin-4, are most suited for development of a simple assay for cervical (pre)cancer. Accuracy of the test could further be improved by combination of several proteins or by combination with a new type of biomarker, e.g., originating from the cervicovaginal microbiome or metabolome.

Keywords: Biomarker; Cervical cancer; Cervical vaginal fluid.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Biomarkers, Tumor / metabolism*
  • Body Fluids / metabolism*
  • Cervix Uteri / metabolism*
  • DNA Methylation
  • Female
  • Humans
  • Mass Screening
  • Middle Aged
  • Neoplasm Proteins / metabolism*
  • Papillomaviridae / physiology
  • Papillomavirus Infections / diagnosis
  • Precancerous Conditions / metabolism
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / metabolism*
  • Uterine Cervical Neoplasms / virology
  • Vagina / metabolism*
  • Vaginal Smears

Substances

  • Biomarkers, Tumor
  • Neoplasm Proteins