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Test Code MISC2MAYOHPP Pancreatic Polypeptide, Plasma

Reporting Name

Pancreatic Polypeptide, P

Useful For

Detection of pancreatic endocrine tumors

 

Assessment of vagal nerve function after meal or sham feeding

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Plasma EDTA


Ordering Guidance


This test should not be requested on patients who have recently received radioactive materials.



Necessary Information


Patient's age must be provided.



Specimen Required


Patient Preparation: Fasting (8 hours)

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions:

1. Place specimen on wet ice and keep cold at all times following collection.

2. Centrifuge (refrigerated centrifuge is not required) and aliquot plasma into plastic vial. Freeze immediately.


Specimen Minimum Volume

0.35 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen 90 days

Reference Values

0-19 years: not established

20-29 years: <228 pg/mL

30-39 years: <249 pg/mL

40-49 years: <270 pg/mL

50-59 years: <291 pg/mL

60-69 years: <312 pg/mL

70-79 years: <332 pg/mL

≥80 years: not established

Day(s) Performed

Sunday, Tuesday

Test Classification

This test was developed, and its performance characteristics 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

83519

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HPP Pancreatic Polypeptide, P 2721-9

 

Result ID Test Result Name Result LOINC Value
8014 Pancreatic Polypeptide, P 2721-9

Clinical Information

Pancreatic polypeptide (PP) is secreted by the pancreas in response to hypoglycemia, ingestion of food, or "sham" feeding (food is chewed, but not swallowed) secondary to vagal nerve stimulation. Secretion is blocked by vagotomy or atropine.

 

The exact physiologic role of PP is undetermined, although the hormone is thought to be involved in exocrine pancreatic secretion and gallbladder emptying.

 

Markedly elevated levels are often associated with endocrine tumors of the pancreas (eg, insulinoma, glucagonoma, PPoma: pancreatic polypeptide-secreting tumor of the pancreas) Patients with diabetes may also have elevated PP levels.

 

A lack of response to sham feeding may indicate vagal nerve damage (eg, surgery-related nerve damage, autonomic nerve disorders). Extensive pancreatic destruction (eg, chronic pancreatitis, pancreatic cancer) may also result in low basal PP levels and a lack of response to sham feeding.

Interpretation

High levels may be seen in pancreatic endocrine tumors, diabetes, and a nonfasting state. Markedly elevated levels may be seen in some pancreatic exocrine tumors.

 

A normal response to a sham feeding consists of a rapid pancreatic polypeptide (PP) rise over baseline followed by a return to baseline. With vagal damage, no increase over baseline is seen.

Method Description

A radioimmunoassay technique is used. The assay system utilizes rabbit-antihuman pancreatic polypeptide (PP) antiserum, a standard or patient plasma specimen, and radiolabeled human PP that has been iodinated by a modified Hunter-Greenwood technique.(Unpublished Mayo method)

Report Available

4 to 8 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Method Name

Radioimmunoassay (RIA)