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Test ID: 199PC Carbohydrate Antigen 19-9 (CA 19-9), Pancreatic Cyst Fluid

Ordering Guidance

This test should not be ordered for pancreatic fluid of noncystic origin (eg, pancreatic duct fluid, peripancreatic fluid) since reference values have not been established for those specimen types. For ordering assistance call 800-533-1710.

Specimen Required

Patient Preparation: For 12 hours before this procedure 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: 1 mL

Useful For

As an adjunct in the assessment of pancreatic cysts, when used in conjunction with carcinoembryonic antigen, amylase, imaging studies and cytology

Method Name

Immunoenzymatic Assay

Reporting Name

CA19-9, Pancreatic Cyst

Specimen Type

Pancreatic Cyst Fluid

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Pancreatic Cyst Fluid Frozen (preferred) 30 days
  Refrigerated  7 days

Clinical Information

Carbohydrate antigen 19-9 (CA 19-9) is a modified Lewis(a) blood group antigen, which has been used as a tumor marker. Serum CA 19-9 concentrations may be elevated in patients with gastrointestinal malignancies such as cholangiocarcinoma, colon cancer, or pancreatic cancer. While serum CA 19-9 is neither sensitive nor specific for pancreatic cancer, concentrations of CA 19-9 in pancreatic cyst fluid may help determine whether a pancreatic cyst is benign.


Cystic lesions of the pancreas are of various types:

-Benign cysts:

 -Inflammatory cysts (pseudocysts)

 -Serous cysts (serous cystadenoma)


-Mucinous cysts:

 -Premalignant (mucinous cystadenoma)

 -Malignant (cystadenocarcinoma, intrapapillary mucinous neoplasia)


Pancreatic cyst fluid CA 19-9 results should be used in conjunction with imaging studies, cytology, and other cyst-fluid tumor markers, such as carcinoembryonic antigen and amylase.

Reference Values

An interpretive report will be provided.


Cyst fluid carbohydrate antigen 19-9 (CA19-9) concentrations less than or equal to 37 U/mL indicate a low risk for a mucinous cyst and are more consistent with serous cystadenoma or pseudocyst. The sensitivity and specificity are approximately 19% and 98%, respectively, at this concentration.


Correlation of these test results with cytology and imaging is recommended.

Clinical Reference

1. Snozek CL, Jenkins SM, Bryant SC, et al: Analysis of CEA, CA19-9 and amylase in pancreatic cyst fluid for diagnosis of pancreatic lesions. Clin Chem. 2008;54(6 Suppl S):A126-127

2. van der Waaij LA, van Dullemen HM, Porte RJ: Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a polled analysis. Gastrointest Endosc. 2005;62:383-389

3. Khalid A, Brugge W: ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenterol. 2007 Oct;102(10):2339-2349

Day(s) Performed

Monday through Friday

Report Available

1 to 3 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.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
199PC CA19-9, Pancreatic Cyst 97750-4


Result ID Test Result Name Result LOINC Value
199P CA19-9, Pancreatic Cyst 97750-4
SITE6 Site 39111-0
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