Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

83342
82037
ThinPrep Screen 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% to 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: 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 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.
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 cervical cytological abnormalities. JAMA 2002;287:2120-2129
ThinPrep Screen, Without Physician Interpretation
Clinical Information: The ThinPrep PAP Test is an alternative preparation method for the cervical
pap screening test. The method utilizes a liquid-base technique that replaces the direct smear method of
the conventional PAP screen. This method is one of several new technologies developed to improve
visualization of cellular material by reducing smearing trauma, air drying artifact, and obscuring blood
and inflammation.In addition, variability in smearing technique is eliminated as the majority of
processing and preparation is performed in the laboratory under controlled conditions.
Current as of January 3, 2013 2:22 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 1739