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

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cancer. Despite this useful conceptual framework, these 7 HPV types have been found in only about 70%
of cervical neoplasms. Additional HPVs including types 42, 43, 44, 45, 51, 52, 56, 58, 59, and 68 have
been identified as the principal HPVs detected in the remaining lesions. HPV DNA also is present in
approximately 10% of women with normal cervical epithelium, but the actual prevalence is strongly
influenced by age and other demographic variables. Prospective studies have shown that 15% to 28% of
HPV DNA-positive women developed squamous intraepithelial neoplasia within 2 years, compared to
only 1% to 3% of HPV DNA-negative women. In particular, the risk of progression for HPV types 16 and
18 was greater (approximately 40%) than for other HPV types. Patients who are positive for a high-risk
HPV type may be referred for colposcopy. For patients with "atypical squamous cells of unknown
significance" (ASCUS) on Pap smear, HPV typing may be used to determine the need for
colposcopy.(5-7) Patients who are negative may be followed according to the usual clinical practice.
While certain HPV types are strongly associated with cervical cancer, there is clear evidence that
cofactors are involved. The nature and roles of these cofactors are under intense study; however, their
contributions to malignant progression are still poorly understood. Some of the cofactors thought to
interact with cancer-associated HPV types in the genesis of cervical malignancy are the herpes viruses,
tobacco products, oral contraceptives, and certain dietary factors.
Useful For: Detection of high-risk genotypes associated with the development of cervical cancer
(3,4) As an aid to triaging women with abnormal Pap smear results
Interpretation: A positive result indicates the presence of human papillomavirus (HPV) DNA due to
1 or more of the following genotypes of the virus: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68.
A negative result indicates the absence of HPV DNA of the target genotypes. For patients with ASCUS
Pap smear results and positive for high-risk HPV types, consider referral for colposcopy if clinically
indicated.(5-7)
Reference Values:
Negative for types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68
Clinical References: 1. Sanclemente G, Gill DK: Human papillomavirus molecular biology and
pathogenesis. J Eur Acad Dermatol Venereol 2001;16(3):231-240 2. Castle PE, Wacholder S, Lorincz
AT, et al: A prospective study of high-grade cervical neoplasia risk among human
papillomavirus-infected women. J Natl Cancer Inst 2002;94(18):1406-1414 3. Brentjens MH,
Yeung-Yue KA, Lee PC, Tyring SK: Human papillomavirus: a review. Dermatol Clin
2002;20(2):315-331 4. Hagensee ME: Infection with human papillomavirus: update on epidemiology,
diagnosis treatment. Curr Infect Dis Rep 2000;2(1):18-24 5. Nguyen HN, Nordqvist SR: The bethesda
system and evaluation of abnormal pap smears. Semin Surg Oncol 1999;16(3):217-221 6. Wright TC Jr,
Cox JT, Massad LS: 2001 consensus guidelines for the management of women with cervical cytological
abnormalities. JAMA 2002;287(16):2120-2129 7. Crum CP, Berkowitz RS: Human papillomaviruses.
Applications, caveats and prevention. J Reprod Med 2002;47(7):519-528
Human Papillomavirus (HPV) Typing In Situ DNA Hybridization
Clinical Information: Many human papillomavirus (HPV)-induced lesions are benign presenting
as warts or condylomas. However, certain HPV types have been strongly associated with risk of
development of cervical, vaginal, and vulvar malignancy.
Useful For: The detection of specific human papillomavirus DNA types in paraffin-embedded
human tissue. These are type 6/11, and/or 16/18/31/33/35/39/45/51/52/56/58/66.
Interpretation: Human papillomavirus (HPV) types 6 and 11 are the predominant viruses associated
with condyloma acuminata (genital warts). The condition usually remains benign. HPV types
16/18/31/33/35/39/45/51/52/56/58/66 frequently are found in CIN III (severe dysplasias and carcinoma
in situ) and cervical cancer.
Reference Values:
Results are reported as positive or negative for types 6, 11, and/or types 16, 18, 31, 33, 35, 39, 45, 51,
52, 56, 58, and 66.
If additional interpretation/analysis is needed, please request 5439 Surgical Pathology Consultation
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