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Epic Test Code LAB10411 Carcinoembryonic Antigen (CEA), Pancreatic Cyst Fluid

Additional Codes

MML Code: CEAPC 

NY State Approved

Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

CEA, Pancreatic Cyst

Method Name

Immunoenzymatic Assay

Specimen Stability Information

Specimen Type Temperature Time Special Container
Pancreatic Cyst Fluid Frozen (preferred) 90 days
  Refrigerated  72 hours
  Ambient  24 hours


Ordering Guidance


This test should not be ordered for pancreatic fluid of noncyst origin (eg, pancreatic duct fluid; peripancreatic fluid) since reference values have not been established for this specimen type. For ordering assistance call 800-533-1710.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Container/Tube: Plain, plastic, screw-top tube

Specimen Volume: 1 mL


Specimen Type

Pancreatic Cyst Fluid

Specimen Minimum Volume

0.5 mL

Reference Values

An interpretive report will be provided.

Report Available

1 to 3 days

Day(s) Performed

Monday through Saturday

CPT Code Information

82378

Reject Due To

Gross hemolysis OK
Hemolysis >5000 mg/dL Reject

Useful For

When used in conjunction with imaging studies, cytology, and other pancreatic cyst fluid tumor markers:

-Distinguishing between mucinous and nonmucinous pancreatic cysts

-Determining the likely type of malignant pancreatic cyst

Clinical Information

Cystic lesions of the pancreas are of various types including:

Benign cysts:

-Inflammatory cysts (pseudocysts)

-Serous cysts (serous cystadenoma)

 

Mucinous cysts:

-Premalignant (mucinous cystadenoma)

-Malignant (cystadenocarcinoma, intrapapillary mucinous neoplasia)

 

The diagnosis of pancreatic cyst type is often difficult and may require correlating imaging studies with results of cytological examination and tumor marker testing performed on cyst aspirates. Various tumor markers have been evaluated to distinguish non-mucinous, nonmalignant pancreatic cysts from mucinous cysts, which have a high likelihood of malignancy. Carcinoembryonic antigen (CEA) has been found to be the most reliable tumor marker for identifying pancreatic cysts that are likely mucinous. In cyst aspirates, CEA concentrations of 200 ng/mL and above are highly suspicious for mucinous cysts. The greater the CEA concentration, the greater the likelihood the mucinous cyst is malignant. However, CEA testing does not reliably distinguish between benign, premalignant, or malignant mucinous cysts. CEA test results should be correlated with the results of imaging studies, cytology, other cyst fluid tumor markers (ie, amylase and CA [carbohydrate antigen] 19-9), and clinical findings for diagnosis.

Interpretation

A pancreatic cyst fluid carcinoembryonic antigen (CEA) concentration greater than or equal to 200 ng/mL is very suggestive for a mucinous cyst but is not diagnostic. The sensitivity and specificity for mucinous lesions are approximately 62% and 93%, respectively, at this concentration. Cyst fluid CEA concentrations less than 5 ng/mL indicate a low risk for a mucinous cyst and are more consistent with serous cystadenoma, fluid collections complicating pancreatitis, cystic neuroendocrine tumor, or metastatic lesions. CEA values between these extremes have limited diagnostic value.

Cautions

These test results should not be the sole basis for diagnosis. Test results should be always correlated with imaging and cytology.

 

This test does not distinguish between malignant and nonmalignant mucinous cysts.

 

In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. Caution should be used in interpretation of results and the laboratory should be alerted if the result does not correlate with the clinical presentation.

Specimen Retention Time

12 months

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.