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MTBS<br />

81507<br />

leucovorin (LV). These findings are most likely to impact the management of patients with stage II<br />

disease.<br />

Useful For: Evaluation of tumor tissue to identify patients at high risk for having hereditary<br />

nonpolyposis colorectal cancer (HNPCC)/Lynch syndrome Note: <strong>Mayo</strong>'s preferred screening test<br />

(HNPCC/17073 Hereditary Nonpolyposis Colorectal Cancer [HNPCC] Screen) includes both<br />

microsatellite instability (MSI) and Immunohistochemistry (IHC) testing. Evaluation of tumor tissue for<br />

clinical decision making purposes given the prognostic implications associated with MSI phenotypes<br />

Interpretation: The report will include specimen information, assay information, and interpretation of<br />

test results. Microsatellite stable (MSS) is reported as MSS/MSI-L (0 or 1 of 5 markers demonstrating<br />

instability) or MSI-H (2 or more of 5 markers demonstrating instability).<br />

Reference Values:<br />

An interpretive report will be provided.<br />

Clinical References: 1. Baudhuin LM, Burgart LJ, Lentovich O, Thibodeau SN: Use of<br />

microsatellite instability and immunohistochemistry testing for the identification of individuals at risk for<br />

Lynch Syndrome. Fam Cancer 2005;4(3):255-265 2. Terdiman JP, Gum JR Jr, Conrad PG, et al: Efficient<br />

detection of hereditary nonpolyposis colorectal cancer gene carriers by screening for tumor microsatellite<br />

instability before germline genetic testing. Gastroenterology 2001 January;120(1):21-30 3. Popat S,<br />

Hubner R, Houlston RS: Systematic review of microsatellite instability and colorectal cancer prognosis.<br />

JCO 2005 23(3):609-618 4. Ribic CM, Sargent DJ, Moore MJ, et al: Tumor microsatellite-instability<br />

status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N Engl J<br />

Med 2003 349:247-57<br />

Microsporidia Stain<br />

Clinical Information: Microsporidia are obligate protozoan parasites which have been documented<br />

to infect invertebrates and vertebrates. They are very small organisms (1-2 microns, about the size of<br />

bacteria) and are classified in a phylum, microspora, characterized by the structure of their spores which<br />

contain polar tubules which are extruded to inject infective material into host cells. The microsporidia<br />

known to infect humans include Enterocytozoon bieneusi (intestinal microsporidiosis), Encephalitozoon<br />

hellem (eye infections), and Enterocytozoon (Septata) intestinalis (intestinal and disseminated infections,<br />

especially to the biliary tree). Human infections have been reported most frequently in patients with<br />

AIDS, but also can occur sporadically in immunocompetent patients. The primary clinical findings are<br />

chronic diarrhea, weight loss, and malabsorption. Enterocytozoon bieneusi is found in the duodenal<br />

mucosa and infection is accompanied by a wide spectrum of histopathologic changes ranging from normal<br />

architecture to almost complete effacement of the villi and virtual obliteration of the lamina propria by<br />

inflammatory cells. The anti-helmintic drug, albendazole has been found effective in some infections due<br />

to Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis.<br />

Useful For: Diagnosis of intestinal microsporidiosis in patients with AIDS and others with unexplained<br />

diarrhea, especially after overseas travel See Parasitic Investigation of Stool Specimens Algorithm in<br />

Special Instructions for other diagnostic tests that may be of value in evaluating patients with diarrhea.<br />

Interpretation: Presence of microsporidia in stool may or may not be associated with symptoms in<br />

infected persons and may or may not be the cause of any symptoms since patients with AIDS may be<br />

infected with more than 1 intestinal pathogen at the same time.<br />

Reference Values:<br />

Negative<br />

If positive, reported as microsporidia<br />

Clinical References: 1. Weber R, Bryan RT, Schwartz DA, Owen RL: Human microsporidial<br />

infections. Clin Microbiol Rev 1994;7:426-461 2. Goodgame RW: Understanding intestinal<br />

spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora. Ann Intern Med<br />

1996;124:429-441 3. Wanke CA, DeGirolami P, Federman M: Enterocytozoon bieneusi infection and<br />

diarrheal disease in patients who were not infected with human immunodefeciency virus: case report and<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1210

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