Lab Test

Pancreatic Fluid Chemical Tests

Fluid Pancreatic

Test Codes

Amylase, Pancreatic Fluid: EPIC: LAB6930, SOFT: AMYPN, CA 19-9, Pancreatic Fluid: EPIC: LAB6957, SOFT: C19PN, CEA, Pancreatic Fluid: EPIC: LAB6961, SOFT: CEAPN,

Note: Royal Oak is the ONLY campus that performs the CA 19-9, Pancreatic Fluid.

Instructions

  • Pancreatic Fluid Chemical testing is available for the following analytes: Amylase, CA 19-9, and CEA. This testing is not a panel and analytes are ordered individually. Please refer to the Lab Test Directory for testing of other analytes and fluid types.
  • Testing of fluid analytes or sources not listed in the Lab Test Directory must be approved by a Medical Director. Please contact the Laboratory for more information.

Specimen Collection Criteria

Collect: Body fluid in a sterile collection container or Vacutainer® tube without additive. (Minimum: 1.0 mL)

Send specimen for processing immediately after collection.

Physician Office/Draw Specimen Preparation

Maintain specimen refrigerated (2-8°C or 36-46°F) prior to transport. Room temperature (20-26°C or 68-78.8°F) is acceptable for a maximum of two hours.

Preparation for Courier Transport

Transport: Body fluid in a sterile collection container or Vacutainer® tube, refrigerated (2-8°C or 36-46°F). (Minimum: 1.0 mL)

Rejection Criteria

Specimens grossly contaminated with blood.

Specimens collected in a container or tube with an additive.

In-Lab Processing

Before chemistry testing, centrifuge to remove cellular material.


Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Undetermined

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 30 days

Laboratory

Farmington Hills Chemistry Laboratory
Grosse Pointe Chemistry Laboratory
Royal Oak Automated Chemistry Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Results available within 4 hours of hours of receipt in the Laboratory.

Reference Range

Reference ranges have not been established.

Test Methodology

  • Chemiluminescence Immunoassay: CA 19-9, CEA.
  • Spectrophotometry: Amylase.

Interpretation

  • Pancreatic pseudocysts generally contain significantly elevated amylase (e.g. greater than 250 IU/L), whereas mucinous and serous cysts and adenocarcinoma usually have lower concentrations.
  • The higher the CEA concentration the more likely a cyst is a mucinous cyst with increased likelihood of malignancy. CEA greater than 200 ng/mL is very suggestive but not diagnostic of a mucinous cyst. Much lower CEA concentrations are usually seen with non-mucinous cysts. Results should be used in conjunction with clinical information, imaging studies, cytology, and pancreatic cyst tumor markers.
  • CA 19-9 concentrations less than or equal to 37 U/mL indicate a low risk for a mucinous cyst, and are more consistent with serous cystadenoma or pseudocyst. However, very low concentrations should be viewed with caution since CA 19-9 is a modified Lewis(a) blood group antigen and may not be produced by Lewis non-secretors.

Clinical Utility

Testing is used to determine whether a pancreatic cyst is likely to be benign or malignant. However, these results cannot be used in isolation and should be used in conjunction with clinical information, imaging studies, and cytology.

Reference

  1. Khalid A, Brugge W. ACG Practice Guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts. Am J Gastroenterology. 2007;102:2339-49.
  2. Bhutani MS, Gupta V, Guha S et al. Pancreati Cyst Fluid Analysis - A Review. J Gastrointestin Liver Des. 2011;20:175-180.
  3. Habashi S, Draganov PV. Pancreatic Pseudocyst. World J Gastroenterol. 2009;15:38-47.
  4. Mayo Medical Laboratory.

CPT Codes

82150 (Amylase), 86301 (CA 19-9), 82378 (CEA).

Contacts

Last Updated

5/4/2020

Microtainer® and Vacutainer® are registered trademarks of Becton, Dickinson and Company.
UroVysion® is a registered trademark of Abbott Laboratories. ThinPrep® is a registered trademark of Hologic, Incorporated.

 

This directory currently reflects information only for specimens collected and/or processed at the
Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.