Ordering Recommendation

Screening test for Lynch Syndrome. Determine potential eligibility for immunotherapy by identifying microsatellite instability-high (MSI-H) cancers. 

Mnemonic
MSI PCR
Methodology

Polymerase Chain Reaction/Fragment Analysis

Performed

DNA isolation: Sun-Sat
Assay: Varies

Reported

10-20 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Collect

Tumor AND normal epithelial tissue. Also acceptable: DNA extracted by CLIA certified

Specimen Preparation

Tissue: Formalin fix (10 percent neutral buffered formalin) and paraffin embed tissue. Protect from excessive heat. Transport tissue block(s) or 10 unstained 5-micron slides (5 tumor and 5 normal epithelial). (Min: 3 tumor tissue and 3 normal epithelial tissue slides) Transport block(s) and/or slide(s) in a tissue transport kit (ARUP Supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Extracted DNA: Transport 40 uL DNA with at least 50 ng/uL concentration. (Min: 40 uL)Transport DNA in a tissue transport kit (ARUP Supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated. Ship in cooled container during summer months
Extracted DNA: Refrigerated.

Unacceptable Conditions

Less than 25 percent tumor or less than 50 percent normal epithelial tissue. DNA extracted by a non-CLIA lab. DNA extracted without a corresponding circled H&E slide. Specimens fixed/processed in alternative fixatives (alcohol, Prefer) or heavy metal fixatives (B-4 or B-5). Decalcified specimens.

Remarks

Include surgical pathology report.

Stability

Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
Extracted DNA: Ambient: 1 month; Refrigerated: Indefinitely; Frozen: Indefinitely

Reference Interval
Interpretive Data

Refer to report.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

88381; 81301

Components
Component Test Code* Component Chart Name LOINC
0051741 Microsatellite Marker BAT-25
0051742 Microsatellite Marker BAT-26
0051743 Microsatellite Marker MONO-27
0051744 Microsatellite Interpretation 43368-0
0051745 Microsatellite Marker NR-21
0051746 Microsatellite Marker NR-24
2001370 Microsatellite Instability Specimen 31208-2
2002148 Block ID 57723-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • BAT -25, BAT-26, MON-27, NR-21, NR-24 genotypes
  • HNPCC MSI
  • HNPCC tumor screening
  • Lynch Syndrome MSI
  • Lynch syndrome tumor screening
  • microsatellite instability
  • MSI
  • MSI Lynch syndrome
Microsatellite Instability (MSI), HNPCC/Lynch Syndrome, by PCR