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Test Code PF199 Carbohydrate Antigen 19-9 (CA 19-9), Pleural Fluid

Reporting Name

CA 19-9, Pleural Fluid

Useful For

An adjuvant to cytology and imaging studies to differentiate between nonmalignant and malignant causes of pleural effusions

Method Name

Immunoenzymatic Assay

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Pleural Fluid


Specimen Required


Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Container/Tube: Plain, plastic, screw-top tube

Specimen Volume: 2 mL


Specimen Minimum Volume

0.5 mL (Samples <0.5 mL may be rejected)

Specimen Stability Information

Specimen Type Temperature Time Special Container
Pleural Fluid Frozen (preferred) 90 days
  Refrigerated  14 days
  Ambient  7 days

Reject Due To

Gross hemolysis Reject
Gross icterus OK

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Saturday

CPT Code Information

86301

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PF199 CA 19-9, Pleural Fluid 19163-5

 

Result ID Test Result Name Result LOINC Value
P199 CA 19-9, Pleural Fluid 19163-5
SITE8 Site 39111-0

Clinical Information

Pleural effusions occur as a consequence of either nonmalignant conditions (including congestive heart failure, pneumonia, pulmonary embolism, and liver cirrhosis) or malignant conditions (including lung, breast, and lymphoma cancers). Diagnosing the cause of an effusion can be difficult, requiring cytological examination of the fluid. Analysis of various tumor markers in pleural fluid has shown that these markers can differentiate between effusions caused by nonmalignant and malignant conditions and can enhance cytology findings.

 

Carbohydrate antigen 19-9 (CA 19-9) is a modified Lewis(a) blood group antigen. Healthy adults typically produce low to undetectable levels of CA 19-9. Serum concentrations of CA 19-9 may be elevated in patients with certain malignancies that secrete CA 19-9 into circulation, including cholangiocarcinoma, colorectal, stomach, bile duct, lung, ovarian, and pancreatic cancers.

 

Pleural fluid concentrations of CA 19-9 have been reported to be elevated in patients with certain malignancies. Malignancies that can secrete CA 19-9 and elevate serum CA 19-9 concentrations, including cholangiocarcinoma, colorectal, stomach, bile duct, lung, ovarian, and pancreatic cancers, typically also elevate CA 19-9 in pleural fluid. In contrast, malignancies that do not secrete CA 19-9, including mesothelioma, lymphoma, leukemia, and melanoma, have low concentrations of CA 19-9 in pleural fluid comparable to concentrations observed in nonmalignant effusions.

CA 19-9 results should be used in conjunction with cytological analysis of pleural fluid, imaging studies, and other clinical findings.

Specimen Retention Time

14 days

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were 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.

Report Available

1 to 3 days

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.