Sign in →

Test ID: AMLPC Amylase, Pancreatic Cyst Fluid

Reporting Name

Amylase, Pancreatic Cyst

Useful For

Aiding in distinguishing between pseudocysts and other types of pancreatic cysts, when used in conjunction with imaging studies, cytology, and other pancreatic cyst fluid tumor markers

Specimen Type

Pancreatic Cyst Fluid


Advisory Information


For other body fluid specimens (eg, peritoneal, pleural), order AMBF / Amylase, Body Fluid. Testing will be changed to AMBF if this test is ordered on any fluid other than pancreatic fluid.



Specimen Required


Supplies: Aliquot Tube, 5 mL (T465)

Container/Tube: Plain, plastic, screw top tube

Specimen Volume: 1 mL

Additional Information: A minimum of 0.5 mL is required for testing; specimens <0.5 mL may be rejected.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

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

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday; 6 a.m.-9 p.m.

Saturday 6:30 a.m.-1 p.m.

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 U.S. Food and Drug Administration.

CPT Code Information

82150

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AMLPC Amylase, Pancreatic Cyst 48996-3

 

Result ID Test Result Name Result LOINC Value
AMYPC Amylase, Pancreatic Cyst 48996-3
SITE6 Site 39111-0

Clinical Information

Amylases are a group of hydrolases that degrade complex carbohydrates into fragments. Amylase is produced by the exocrine pancreas and the salivary glands to aid in the digestion of starch. It is also produced by the small intestine mucosa, ovaries, placenta, liver, and fallopian tubes.

 

Measurement of amylase in pancreatic cyst fluid is often used in conjunction with tumor markers, carcinoembryonic antigen and CA19-9, as an aid in the differential diagnosis of pancreatic cysts lesions. Amylase seems to be particularly helpful in excluding pancreatic pseudocysts. A number of studies have demonstrated that amylase levels are typically very high, usually in the thousands in pseudocysts, therefore, low amylase values virtually excludes pseudocysts. Based on the evidence available, the American College of Gastroenterology (ACG) practice guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts suggest that an amylase cutoff value of 250 U/L is useful to exclude pseudocysts.

Interpretation

A pancreatic cyst fluid amylase concentration of less than 250 U/L indicates a low risk of a pseudocyst and is more consistent with cystic neoplasms such as mucinous cystic neoplasms (MCN), intraductal papillary mucinous neoplasm (IPMN), serous cystadenomas, cystic neuroendocrine tumor, and mucinous cystadenocarcinoma. High pancreatic cyst fluid amylase values are nonspecific and occur both in pseudocysts and some mucin-producing cystic neoplasms including MCN, IPMN, and mucinous cystadenocarcinoma.

 

In-house studies to verify this cutoff value showed that 94% (66/70) of pseudocysts had a value of greater or equal to 250 U/L. Cysts with amylase levels of less than 250 U/L included 69% of adenocarcinomas, 31% of intraductal papillary mucinous neoplasia, 55% of mucinous cystadenomas, 64% serous cystadenomas, and 6% of pseudocysts. Therefore, using a cutoff of less than 250 U/L to exclude a pseudocyst has 94% sensitivity and 42% specificity.

Clinical Reference

1. Snozek CL, Mascarenhas RC, O'Kane DJ: Use of cyst fluid CEA, CA19-9, and amylase for evaluation of pancreatic lesions. Clin Biochem. 2009;42:1585-1588

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

3.  Elta GH, Enestvedt BK: ACG clinical guideline for the diagnosis and management of pancreatic cysts. Am J Gasroenterol. 2018;113:464-479

4. Brugge WR: Diagnosis and management of cystic lesions of the pancreas. J Gastrointest Oncol. 2015;6(4):375-388. doi:10.3978/j.issn.2078-6891.2015.057

Analytic Time

Same day/1 day

Method Name

Substrate Kinetic

Mayo Clinic Laboratories | Gastroenterology Catalog Additional Information:

mml-gi-pancreas-cancer