Sorted By Test Name - Mayo Medical Laboratories

84357
19701
Interpretation: Total bile acids are metabolized in the liver and can serve as a marker for normal liver
function. Increases in serum bile acids are seen in patients with acute hepatitis, chronic hepatitis, liver
sclerosis, and liver cancer.
Reference Values:
< or =10 mcmol/L
Clinical References: 1. Diazyme Total Bile Acids Assay Kit Package insert, Diazyme Laboratories,
Poway, CA, April 2008 2. Total bile Acids Test and Clinical Diagnosis, Publication by Diazyme
Laboratories, Poway, CA
Biliary Tract Malignancy, Cytology & Molecular Testing
Clinical Information: Endoscopic retrograde cholangiopancreatography (ERCP) is used to examine
patients with biliary tract obstruction or stricture for possible malignancy. Biopsies and cytologic
specimens are obtained at the time of ERCP. Cytologic analysis complements biopsy by sometimes
detecting malignancy in patients with a negative biopsy. Nonetheless, a number of studies suggest that the
overall sensitivity of bile duct brushing and bile aspirate cytology is quite low. FISH is a technique that
utilizes fluorescently labeled DNA probes to examine cells for chromosomal alterations. FISH can be
used to detect cells with chromosomal changes (eg, aneuploidy) that are indicative of malignancy. Studies
in our laboratory indicate that the sensitivity of FISH to detect malignant cells in biliary brush and bile
aspirate specimens is superior to that of conventional cytology.
Useful For: Assessing bile duct brushing or hepatobiliary brushing specimens for malignancy
Interpretation: The chance that the patient has cancer is calculated based on the following parameters:
patient age, cytology results (negative, atypical, suspicious, positive, not available), FISH results
(negative, trisomy, polysomy, not available), and primary sclerosing cholangitis (PSC) status (non-PSC
vs. PSC patient). This information is then provided in the interpretive portion of the final report.
Reference Values:
An interpretive report will be provided.
Clinical References: 1. Kipp BR, Stadheim LM, Halling SA, et al: A comparison of routine
cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am J
Gastroenterol 2004 September;99(9):1675-1681 2. Moreno Luna LE, Kipp BR, Halling KC, et al:
Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures.
Gastroenterology 2006 October;131(4):1064-1072 3. Barr Fritcher EG, Kipp BR, Slezak JM, et al:
Correlating routine cytology, quantitative nuclear morphometry by digital image analysis, and genetic
alterations by fluorescence in situ hybridization to assess the sensitivity of cytology for detecting
pancreatobiliary tract malignancy. Am J Clin Pathol 2007 August;128(2):272-279
Biliary Tract Malignancy, FISH Only
Clinical Information: Endoscopic retrograde cholangiopancreatography (ERCP) is used to examine
patients with biliary tract obstruction or stricture for possible malignancy. Biopsies and cytologic
specimens are obtained at the time of ERCP. Cytologic analysis complements biopsy by sometimes
detecting malignancy in patients with a negative biopsy. Nonetheless, a number of studies suggest that the
overall sensitivity of bile duct brushing and bile aspirate cytology is quite low. FISH is a technique that
utilizes fluorescently labeled DNA probes to examine cells for chromosomal alterations. FISH can be
used to detect cells with hromosomal changes (eg, aneuploidy) that are indicative of malignancy. Studies
in our laboratory indicate that the sensitivity of FISH to detect malignant cells in biliary brush and bile
aspirate specimens is superior to that of conventional cytology.
Useful For: Assessing bile duct brushing or hepatobiliary brushing specimens for malignancy
Interpretation: The chance that the patient has cancer is calculated based on the following parameters:
patient age, FISH results (negative, trisomy, polysomy), and primary sclerosing cholangitis (PSC) status
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