HPV DNA Probe Test: Detection, Genotyping, and Clinical Significance
Synonyms
DNA Probe Test for HPV, HPV Screen, HPV Type, DNA Hybridization Test for HPV
Test Commonly Includes
Detection of HPV DNA in cervical and vulvar specimens and identification of specific HPV genotypes (e.g., 6, 11, 16, 18, 31, 33, 35).
Abstract
HPV is a sexually transmitted virus that infects squamous epithelium and plays a major role in cervical intraepithelial neoplasia (CIN) and carcinoma. The DNA probe test detects and types HPV directly in biopsy or swab samples. HPV typing is increasingly being used to guide clinical decisions, though its full utility is still under evaluation.
Patient Care / Preparation
- Swab collection must be at least 48 hours after acetic acid or iodine use.
- Biopsies can be collected immediately after acetic acid or iodine application.
Specimen
- Cervical swabs
- Cervical and vulvar biopsies (≤3 mm)
Container
Use lab-provided transport medium. Do not substitute containers.
Collection
Collect ectocervical and endocervical cells using lab-supplied swabs or spatulas. Avoid causing bleeding. Place samples into provided transport medium.
Storage Instructions
- Freeze biopsies immediately in transport medium.
- Swabs may be stored at room temperature but are best frozen immediately.
Reason to Reject Sample
- Bloody specimens (may yield false negatives)
- Non-designated transport medium
Turnaround Time
Typically 4 days to 2 weeks, depending on the lab and reagent stability.
Use
Assists clinicians in managing, following up, and prognosticating HPV-related conditions, especially cervical squamous intraepithelial lesions (SIL).
Limitations
- Detects only selected genotypes (6, 11, 16, 18, 31, 33, 35)
- HPV may be present without cytologic abnormalities
- False negatives may occur if sample is bloody or has insufficient cells
- Latent infection may not cause visible cellular changes
- Expensive and not FDA approved for genotyping (as of 1993)
Methodology
Samples are digested, and DNA is isolated, fixed on a filter, and hybridized with radiolabeled RNA probes specific for HPV types 6, 11, 16, 18, 31, 33, and 35.
Additional Information
HPV types have varying oncogenic potential:
- Low risk: HPV 6, 11 (linked to genital warts)
- High risk: HPV 16, 18 (linked to CIN 2/3 and cervical cancer)
- Moderate risk: HPV 31, 33, 35
HPV 16 is found in 50% of invasive squamous cell carcinoma cases. Typing may help stratify cancer risk, but routine use is not yet established.
References
- Jacobs et al., “Laboratory Test Handbook”, Lexi-Comp Inc, 1994
- Meanwell CA et al., Lancet, 1987
- deVilliers EM et al., Lancet, 1987
- Kurman RJ, Univ. of Texas Southwestern, 1993
- Chang F, J Clin Pathol, 1990
- Bauer HM et al., JAMA, 1991
- Shah KV, Buscema J, Annu Rev Med, 1988
