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HPV mRNA E6/E7

Test code(s) 90887, 90942, 91932, 93101, 93136

Question 1. Why order the HPV mRNA E6/E7 test instead of a high-risk HPV DNA test?

The HPV mRNA E6/E7 test uses the Aptima® HPV mRNA method, which is shown to be more specific than an HPV DNA test.1,2 This can lead to fewer false-positive results and unnecessary invasive procedures such as, colposcopy and biopsy.

The mRNA test determines the presence of E6/E7 mRNA from 14 high-risk HPV genotypes. HPV E6/E7 oncoproteins mediate the development of cervical cancer. Their overexpression, which can be measured as E6/E7 messenger RNA (mRNA) transcripts, is associated with a significantly increased risk of CIN and cervical cancer.3,4

For test codes specific to high-risk HPV mRNA E6/E7 testing for cervical specimens, please refer to the Quest Diagnostics Test Center at http://www.questdiagnostics.com/testcenter/TestCenterHome.action.

Question 2. What is the current recommended use of high-risk HPV testing?

Current American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines recommend high-risk HPV testing for women aged 30 to 65 years as part of a cervical cancer screen. The HPV test is used in conjunction with cervical cytology (cotesting, which is the preferred screening method) every 5 years. Some women >65 years may need high-risk HPV testing too; please refer to the ASCCP Consensus Guidelines.5

The ASCCP does not recommend routine high-risk HPV testing for women 21 to 29 years of age.5

Question 3. Can the HPV mRNA E6/E7 test be performed on anal/rectal specimens?

Yes. Quest Diagnostics Infectious Disease, San Juan Capistrano has validated the test for rectal swab specimens submitted in a 3-mL liquid cytology (PreservCT®) vial. The test name is HPV mRNA E6/E7, Rectal (test code 91932).

Two additional tests related to anal/rectal specimens for HPV mRNA E6/E7 testing include:

  • HPV mRNA E6/E7, Rectal with Reflex to Genotypes 16,18/45 (test code 92810)
  • HPV Genotypes 16,18/45, Anal-Rectal (test code 92807)

Question 4. Can the HPV mRNA E6/E7 test be performed on a post-hysterectomy vaginal specimen?

Yes. Quest Diagnostics Infectious Disease has validated the test for post-hysterectomy vaginal specimens collected in 3-mL (1.5 mL minimum) PreservCyt® transport medium (Thin Prep®) vials. The test name is HPV mRNA E6/E7, Post-Hysterectomy, Vaginal (test code 93101).

We also offer HPV mRNA E6/E7, Post-Hysterectomy, Vaginal with Reflex to HPV 16,18/45 (test code 93136) and HPV Genotypes 16,18/45, Post-Hysterectomy, Vaginal (test code 93102).

References

  1. APTIMA® HPV Assay [package insert]. San Diego, CA: Gen-Probe, Inc; 2011. http://gen-probe.com/pdfs/pi/502170-EN-RevA.pdf. Accessed December 3, 2013.
  2. Ratnam S, Coutlee F, Fontaine D, et al. Aptima HPV E6/E7 mRNA test is as sensitive as Hybrid Capture 2 assay but more specific at detecting cervical precancer and cancer. J Clin Microbiol. 2011;49:557-564.
  3. Cuschieri KS, Whitley MJ, Cubie HA. Human papillomavirus type specific DNA and RNA persistence—implications for cervical disease progression and monitoring. J Med Virol. 2004;73:65-70.
  4. Monsonegro J, Hudgens MG, Zerat L, et al. Risk assessment and clinical impact of liquid-based cytology, oncogenic human papillomavirus (HPV) DNA and mRNA testing in primary cervical cancer screening (the FASE study). Gynecol Oncol. 2012;125:175-180.
  5. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Cytology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012;137:516-542.
  6. American College of Obstetricians and Gynecologists. Practice Bulletin No. 140: management of abnormal cervical cancer screening test results and cervical cancer precursors. Obstet Gynecol. 2013;122:1338-1367.
  7. American College of Obstetricians and Gynecologists. Practice Bulletin No. 168 Summary: Cervical Cancer Screening and Prevention. Obstet Gynecol. 2016;128:923-925.
This FAQ is provided for informational purposes only and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.
Document FAQS.129 Version: 2
Version 2 effective 01/04/2017 to present
Version 1 effective 02/28/2014 to 01/04/2017
Version 0 effective 01/14/2014 to 02/27/2014