Sorted By Test Name - Mayo Medical Laboratories

83343
High Risk HPV DNA Detection:
Negative for types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68
Clinical References: 1. Lorincz AT, Richart RM: Human papillomavirus DNA testing as an adjunct
to cytology in cervical screening programs. Arch Pathol Lab Med 2003 August;127(8):959-968 2. Wright
TC, Jr, Schiffman M: Adding a test for human papillomavirus DNA to cervical-cancer screening. N Engl
J Med 2003 February 6;348(6):489-490 3. Soloman D, Davey D, Kurman R, et al: The 2001 Bethesda
System: terminology for reporting results of cervical cytology. JAMA 2002 April;287(16):2114-2119 4.
Sherman ME, Lorincz A, Scott DR, et al: Baseline cytology, human papillomavirus testing, and risk for
cervical neoplasia: a 10-year cohort analysis. J Nat Cancer Inst 2003 January;95(1):46-52
ThinPrep Diagnostic with Human Papillomavirus (HPV) Reflex
Clinical Information: Squamous cell carcinoma of the cervix is believed to develop in progressive
stages from normal through precancerous (dysplastic) stages, to carcinoma in situ, and eventually invasive
carcinoma. This sequence is felt to develop over a matter of years in most patients. Follow up of the
cervical Pap abnormality "atypical squamous cells of undetermined significance (ASCUS)" is costly and
frustrating to patients and clinicians because a large percentage of these patients have normal colposcopic
and biopsy findings. Yet, a significant percentage (10%-15%) will have an underlying high grade
squamous intraepithelial lesion (HSIL). The majority (>99%) of cervical epithelial neoplasms are the
result of human papillomavirus (HPV) infection. Some HPV types ("low-risk" types 6 and 11) are
associated with low-grade squamous intraepithelial lesions (LSIL) that are benign and do not progress to
carcinoma. "High-risk" HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) can result in
both LSIL and HSIL, as well as invasive carcinomas. Patients with HSIL have a greater risk for
progression to carcinoma. In the setting of an ASCUS Pap result, the presence of high-risk HPV types in
cervical specimens identifies a subgroup of patients with a greater likelihood of having a HSIL.
Useful For: Detection of cervical carcinoma and a number of infectious conditions Triage of equivocal
Pap abnormalities (atypical squamous cells of undetermined significance [ASCUS])
Interpretation: The Pap report in an estimate of the nature of the abnormality using the Bethesda
nomenclature. Specimen adequacy is characterized as: -Satisfactory for evaluation (with quality indicators
if applicable) -Unsatisfactory for evaluation, further subdivided as follows: - Specimen processed and
examined but unsatisfactory for evaluation of epithelial abnormality because of scanty cellularity,
obscuring blood or inflammation, etc. - Specimen rejected because of a broken slide, unlabeled specimen,
etc. The diagnostic interpretation may include: -Negative for intraepithelial lesion or malignancy (NIL)
-Atypical squamous cells of undetermined significance (ASCUS) characterized further as either: -
Atypical squamous cells of undetermined significance - Atypical squamous cells, cannot exclude
high-grade intraepithelial lesion -Low-grade squamous intraepithelial lesion (LSIL), which includes mild
squamous dysplasia (cervical intraepithelial neoplasia I [CINI]) and koilocytotic changes consistent with
human papillomavirus (HPV) effect -High-grade squamous intraepithelial lesion (HSIL), which includes
moderate squamous dysplasia (CINII), severe squamous dysplasia (CINIII), and squamous carcinoma in
situ (CINIII) -Atypical glandular cells: Patients with this diagnosis are at increased risk for a clinically
significant lesion, including adenocarcinoma in situ, high-grade squamous intraepithelial lesion, invasive
cervical carcinoma, or endometrial carcinoma and should have appropriate clinical follow-up that may
include gynecologic examination, colposcopy, or biopsy. HPV: A positive HPV test result indicates the
presence of one or more of the high-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, or 68).
Reference Values:
Satisfactory for evaluation. Negative for intraepithelial lesion or malignancy.
Note: Abnormal results will be reviewed by a pathologist at an additional charge.
Clinical References: 1. Solomon D, Schiffman M, Tarone R: Comparison of three management
strategies for patients with atypical squamous cells of undetermined significance: baseline results from a
randomized trial. J Natl Cancer Inst 2001;93:293-299 2. Soloman D, Davey D, Kurman R, et al: The 2001
Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002;287:2114-2119 3.
Wright TC, Cox JT, Massad LS,et al: 2001 Consensus Guidelines for the management of women with
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