Test Catalog

Test Id : CEAPC

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Carcinoembryonic Antigen (CEA), Pancreatic Cyst Fluid

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Method Name
A short description of the method used to perform the test

Immunoenzymatic Assay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

CEA, Pancreatic Cyst

Aliases
Lists additional common names for a test, as an aid in searching

CEA (Carcinoembryonic Antigen)

Specimen Type
Describes the specimen type validated for testing

Pancreatic Cyst Fluid

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.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
SITE6 Site

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

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

Specimen Volume: 1 mL

Forms

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

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Hemolysis >5000 mg/dL Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

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
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Interpretation
Provides information to assist in interpretation of the test results

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
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

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.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Brugge WR, Lewandrowski K, Lee-Lewandrowski E, et al. Diagnosis of pancreatic cystic neoplasms: a report of cooperative pancreatic cyst study. Gastroenterology. 2004;126(5):1330-1336

2. Snozek CL, Jenkins SM, Bryant SC, et al.: Analysis of CEA, CA 19-9, and amylase in pancreatic cyst fluid for diagnosis of pancreatic lesions. Clin Chem. 2008;54(Suppl S):A126-127

3. Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenterol. 2007;102(10):2339-2349

4. Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol. 2018;113(4):464-479. doi:10.1038/ajg.2018.14

Method Description
Describes how the test is performed and provides a method-specific reference

The Access carcinoembryonic antigen (CEA) assay is a 2-site immunoenzymatic sandwich assay using 2 mouse monoclonal anti-CEA antibodies (Mab) that react with different epitopes of CEA. A sample is added to a reaction vessel, along with the first anti-CEA Mab-alkaline phosphatase conjugate and the second anti-CEA Mab bound to paramagnetic particles. The incubation is followed by a magnetic separation and washing. The chemiluminescent substrate Lumi-Phos 530 is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is proportional to the concentration of CEA in the sample. The amount of analyte in the sample is determined by means of a stored, multipoint calibrator curve.(Package insert: Access CEA. Beckman Coulter, Inc.; 2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

12 months

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82378

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CEAPC CEA, Pancreatic Cyst 97747-0
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
SITE6 Site 39111-0
CEAP CEA, Pancreatic Cyst 97747-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports