Test Catalog

Test Id : KINET

Ki-67(MIB-1), Gastrointestinal/Pancreatic Neuroendocrine Tumors, Quantitative Immunohistochemistry, Automated

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining proliferation of tumor cells in paraffin-embedded tissue blocks from patients diagnosed with neuroendocrine tumors of the pancreas or gastrointestinal tract including metastases

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
KINM Ki67 GI/Pancreas NET IHC Manual No No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Cases that are not able to be scanned for automated analysis will be changed to the manual process for analysis.

Method Name
A short description of the method used to perform the test

Immunohistochemistry, Automated Quantitation, Hot-Spot Technique

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Ki67 GI/Pancreas NET IHC Automated

Aliases
Lists additional common names for a test, as an aid in searching

Automated, Quantitative MIB-1

Ki-67

MIB-1

ISDIAKI67NIHC

Ki-67 GI/Pancre NET IHC stain, RST

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Cases that are not able to be scanned for automated analysis will be changed to the manual process for analysis.

Specimen Type
Describes the specimen type validated for testing

Special

Ordering Guidance

If ordering for diagnostic purposes, order PATHC / Pathology Consultation and request the stain.

Shipping Instructions

Attach the green pathology address label included in the kit to the outside of the transport container.

Necessary Information

1. Pathologist's name, address, and phone number are required.

2. Include accompanying pathology report stating the final diagnosis. If not available, a preliminary diagnosis is acceptable.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Pathology Packaging Kit (T554)

 

Specimen Type:

Preferred: Formalin-fixed, paraffin-embedded tissue block containing neuroendocrine tumor of the pancreas or gastrointestinal (GI) tract including metastases.

Acceptable: 2 unstained sections, containing neuroendocrine tumor of the pancreas or GI tract including metastases, on charged slides cut at 4 microns <1 month ago. Tissue on the slides should have been fixed in 10% neutral buffered formalin.

Submission Container/Tube: Pathology Packaging Kit (T554)

Collection Instructions: Submit formalin-fixed, paraffin-embedded tissue block.

Additional Information: Paraffin block will be returned with the final report.

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Oncology Test Request (T729)

-Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request (T763)

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

No specimen should be rejected.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Special Ambient (preferred)
Refrigerated

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining proliferation of tumor cells in paraffin-embedded tissue blocks from patients diagnosed with neuroendocrine tumors of the pancreas or gastrointestinal tract including metastases

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Cases that are not able to be scanned for automated analysis will be changed to the manual process for analysis.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Ki-67(MIB-1 clone) is a monoclonal antibody that reacts with cells undergoing DNA synthesis by binding to the Ki-67 antigen, a marker known to be expressed only in proliferating cells. By measuring the amount of tumor cells expressing Ki-67, an estimate of DNA synthesis can be determined. Studies suggest that Ki-67(MIB-1) analysis of paraffin-embedded tissue specimens may provide useful prognostic information in various tumor types.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Varies by tumor type; values reported from 0% to 100%

Interpretation
Provides information to assist in interpretation of the test results

Results will be reported as a percentage of tumor cells staining positive for Ki-67(MIB-1). Quantitative Ki-67(MIB-1) results should be interpreted within the clinical context for which the test was ordered.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Due to the limitations of the Aperio system (fixed rectangle size and the inability of the machine to distinguish stroma, benign, etc) small or focal tumors will be reflexed (by a pathologist) to a manual semiquantitation method rather than an automated measurement.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Bosman F, Carneiro F, Hruban R, et al: WHO classification of tumours of the digestive system. Lyon: International Agency for Research on Cancer, 2010

2. Hochwald SN, Zee S, Conlon KC, et al: Prognostic factors in pancreatic endocrine neoplasms: an analysis of 136 cases with a proposal for low-grade and intermediate-grade groups. J Clin Oncol 2002;20:2633-2642

3. Klimstra DS, Modlin IR, Coppola D, et al: The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas 2009;39:707-712

4. Klimstra DS, Modlin IR, Adsay NV, et al: Pathology reporting of neuroendocrine tumors: application of the Delphic consensus process to the development of a minimum pathology data set. Am J Surg Pathol 2010;34:300-313

5. Pathology and Genetics Tumours of Endocrine Organs. Edited by RA DeLellis, RV Lloyd, PU Heitz, C Eng. IARC Press, 2004

Method Description
Describes how the test is performed and provides a method-specific reference

A 4-micron thick section is cut from the paraffin block. The section is stained with an immunoperoxidase method using the monoclonal antibody Ki-67 (MIB-1 clone). This is the paraffin nuclear epitope to the Ki-67 antigen. Any nucleus that has an antigen-antibody complex will cause the bright-field, brown chromogen, diaminobenzidine (DAB), to precipitate onto it. All nuclei, both DAB-positive and -negative, are counterstained with diluted hematoxylin.

 

Ki-67 (MIB-1) quantification using the Aperio system in neuroendocrine tumors has been validated by our laboratory. Ki-67 (MIB-1)-stained slides are scanned using the Aperio ScanScope instrument, which captures digital images of the patient slide. A technologist views the digitized image on a computer monitor and using a rectangle tool available in ImageScope (Aperio Technologies Inc), identifies up to ten "hot" regions of the most intensely staining areas within the tumor. The selected areas are then analyzed using an image analysis algorithm that renders the percentage of positive-staining tumor nuclei. The slides and test results are then reviewed by a pathologist who provides a final interpretation.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

4 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 week after results are reported; Material made at Mayo Clinic may be retained at Mayo Clinic indefinitely.

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics 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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

88361

LOINC® Information

Test Id Test Order Name Order LOINC Value
KINET Ki67 GI/Pancreas NET IHC Automated 29593-1
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
71385 Interpretation 29593-1
71402 Participated in the Interpretation No LOINC Needed
71403 Report electronically signed by 19139-5
71404 Material Received 81178-6
71628 Disclaimer 62364-5
71842 Case Number 80398-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports