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HelpTest Code ATPCO Anal ThinPrep Cytology with Human Papillomavirus (HPV) Co-Test, Varies
Necessary Information
1. The following information must accompany the specimen: Patient's name, medical record number, date of birth, sex, source (exact location and procedure used), date specimen was taken, name of ordering physician and pager number.
2. Submit any pertinent history or clinical information.
Specimen Required
Supplies: PreservCyt Vial (T536)
Specimen Type: Anus or rectum
Container/Tube: ThinPrep/PreservCyt solution vial
Specimen Volume: A minimum of 20 mL or entire collection
Collection Instructions:
1. Visualize the anal opening by retracting the buttocks.
2. Moisten Dacron or polyester swab past internal anal sphincter until it abuts the distal rectal wall (4-5cm).
3. Rotate the swab 360 degrees and maintain lateral pressure on swab against the walls of the anus. The swab should bow slightly due to the pressure.
4. While rotating, slowly withdraw the swab.
5. Rotate at least 10 times while withdrawing the swab. This should take 20 to 30 seconds.
6. Immediately place swab in the ThinPrep solution. Swish at least 20 to 30 seconds in the ThinPrep solution.
7. Dispose of the swab.
8. Tighten the cap so that the torque line on the cap passes the torque line on the vial.
9. Place labels on the vial and on the bag.
10. Bag ThinPrep specimens individually as they tend to leak during transport.
Useful For
Detection of malignant and premalignant changes
Detection of high-risk (HR) genotypes associated with the development of anal cancer
Individual genotyping of human papillomavirus (HPV)-16 and HPV-18, if present
May aid in triaging men and women with positive HR-HPV but negative anal Pap smear results
The cobas HPV test is not recommended for evaluation of suspected sexual abuse.
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| AHPV | HPV Anal Detect / Genotyping PCR | No | Yes |
Testing Algorithm
When this test is ordered, a cytology screen and genotyping for high-risk human papillomavirus types will be performed.
Method Name
ATPCO: Light Microscopy
AHPV: Real-Time Polymerase Chain Reaction (PCR)
Reporting Name
Anal ThinPrep Cytology w/HPV CoTestSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient | 21 days | THIN PREP |
Reference Values
ThinPrep ANAL SWAB
Satisfactory for evaluation. Negative for intraepithelial lesion or malignancy.
HUMAN PAPILLOMAVIRUS (HPV)
Negative for HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68
Interpretation
Cytology:
Suspicious or atypical results need further confirmation: clinical observation, repeat cytology, or perhaps appropriate biopsy.
Positive results should be confirmed by histologic examination of tissue before definitive therapy is instituted.
Human papillomavirus:
A positive result indicates the presence of human papillomavirus (HPV) DNA due to 1 or more of the following genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68.
A negative result indicates the absence of HPV DNA of the targeted genotypes. Management of abnormal results requires consideration of baseline risk of anal cancer and prior anal cytology and HPV results.
For patients with an anal Pap test result showing atypical squamous cells of undetermined significance (ASC-US) and who are positive for high-risk (HR) HPV, consider referral for anoscopy, if clinically indicated.
For men and women with a negative anal Pap test result but who are positive for HPV-16 or HPV-18, consider referral for anoscopy, if clinically indicated.
For men and women with a negative anal Pap smear, positive-HR-HPV test result, but who are negative for HPV-16 and HPV-18, consider repeat testing by both cytology and HR-HPV in 12 months.
Clinical Reference
1. Swanson AA, Hartley C, Long ME, et al: Evaluation of high-risk human papillomavirus testing and anal cytology to detect high-grade anal intraepithelial neoplasia. J Am Soc Cytopathol. 2021 Jul-Aug;10(4):406-413. doi: 10.1016/j.jasc.2021.03.007
2. Libera SD, et al. 2019. Human papillomavirus and anal cancer: Prevalence, genotype distribution, and prognosis aspects from Midwestern region of Brazil. J Oncol. Sep 18; 2019:6018269
3. Wieland U, and Kreuter A: Anal cancer risk: HPV-based cervical screening programmes. Lancet Infect Dis. 2019 Aug:19(8):799-800
Day(s) Performed
Monday through Friday
Report Available
3 to 6 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
ATPCO – 88112
AHPV - 87624
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ATPCO | Anal ThinPrep Cytology w/HPV CoTest | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 614403 | Interpretation | 69965-2 |
| 614404 | Participated in the Interpretation | No LOINC Needed |
| 614405 | Report electronically signed by | 19139-5 |
| 614406 | Addendum | 35265-8 |
| 614407 | Gross Description | 22634-0 |
| CY088 | Source | 22633-2 |
| CY089 | Clinical History | 22636-5 |
| 614408 | Disclaimer | 62364-5 |
| 614409 | Case Number | 80398-1 |