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HelpTest Code CEA-O CEA, Body Fluid
Useful For
Aids in distinguishing between mucinous and non-mucinous pancreatic cysts and likelihood of a malignant pancreatic cyst when used in conjunction with imaging studies cytology and other pancreatic cyst tumor markers.
An adjuvant to cytology and imaging studies to differentiate between nonmalignant and malignant causes of pleural effusions & peritoneal fluid.
Synonyms/Keywords
Body Fluid CEA, Carcinoembryonic Ag-Other
Specimen Requirements
| Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|
| Pancreatic Cyst Fluid / Body Fluid | Body Fluid Container | Plastic Vial | 300 uL | 100 uL | N/A |
Collection/Processing Instructions
Do not collect the specimen with preservatives or anticoagulants.
Specimens should be centrifuged to remove cells or clots, if present.
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Pancreatic Cyst Fluid / Body Fluid | Ambient | N/A |
| Refrigerated | 7 days | |
| Frozen at -20 deg Celsius | 30 days | |
| Frozen at -70 deg Celsius | > 30 Days | |
| One freeze and thaw cycle acceptable | ||
Rejection Criteria
Blood or Urine
Interferences
The possibility exists for interference by heterophile antibodies & HAMA in the patient sample regularly exposed to animals or has received immunotherapy or diagnostic procedures utilizing immunoglobulins or immunoglobulin fragments.
Interpretations
Diagnosis of a pancreatic cyst is often difficult and requires correlation of imaging studies, cytology studies and tumor marker results on cyst aspirates. Carcinoembryonic antigen (CEA) has been found to be most helpful tumor marker in differentiating between mucinous and non-mucinous pancreatic cysts. Higher concentrations of CEA have greater likelihood that mucinous cyst may be malignant but CEA does not distinguish between benign, premalignant or malignant mucinous cysts.
Based on evidence available and recommendations by the American College of Gastroenterology (ACG) practice guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts (Am. J. Gastroenterol. 2007; 102: 2339-2349), a pancreatic cyst fluid CEA concentration > 800 ng/ml has high specificity to exclude pseudocysts and concentration > 200 ng/mL is suggestive but not diagnostic of mucinous cyst. Cyst fluid concentrations of ≤ 5 ng/ml indicate low risk for mucinous cyst and are more consistent of serous cystadenoma.
This test does not distinguish between malignant and non-malignant mucinous cysts. Test should not be ordered for pancreatic fluid of non-cyst origin.
Reference Range Information
| Performing Location | Reference Range |
|---|---|
| Marshfield | Reference cut-off limits for CEA for pancreatic cyst fluid and other body fluids have not been established and verified. The test results should not be the sole basis of diagnosis and always be correlated with imaging and cytology. |
Marshfield Labs Performing Department
Marshfield Labs Chemistry
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Sunday | Less than 2 hours | Two-step Sandwich Immunoassay using Direct Chemiluminometric Technology/Siemens Centaur |
CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 82378 |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 82378 |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | CEA, Body Fluid |