Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

19701
BILID
81787
(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
(non-PSC versus 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
Bilirubin Direct, Serum
Clinical Information: Approximately 85% of the total bilirubin produced is derived from the heme
moiety of hemoglobin while the remaining 15% is produced from the red blood cell precursors destroyed
in the bone marrow and from the catabolism of other heme-containing proteins. After production in
peripheral tissues, bilirubin is rapidly taken up by hepatocytes where it is conjugated with glucuronic acid
to produce mono- and diglucuronide, which are excreted in the bile. Direct bilirubin is a measurement of
conjugated bilirubin. Jaundice can occur as a result of problems at each step in the metabolic pathway.
Disorders may be classified as those due to: increased bilirubin production (e.g. hemolysis and ineffective
erythropoiesis), decreased bilirubin excretion (e.g. obstruction and hepatitis), and abnormal bilirubin
metabolism (e.g. hereditary and neonatal jaundice). Inherited disorders in which direct bilirubinemia
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