Test Id : 5NTD
5'-Nucleotidase, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding diagnosis and monitoring of hepatobiliary disease and bile duct obstructions
Ruling out bone pathology as the source of elevated serum alkaline phosphatase
Method Name
A short description of the method used to perform the test
Coupled Enzyme Kinetic Assay
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
5'NT
5NT
ABC
ABCD
Specimen Type
Describes the specimen type validated for testing
Serum
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
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 |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding diagnosis and monitoring of hepatobiliary disease and bile duct obstructions
Ruling out bone pathology as the source of elevated serum alkaline phosphatase
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
5'-Nucleotidase (5'NT) is an enzyme that catalyzes the hydrolysis of the phosphate group from 5'-nucleotides. Increased enzyme levels in sera are associated with certain forms of liver disease, such as intra- or extra-hepatic obstruction, and particularly in cases of hepatic carcinoma and in mastectomy patients with recurrent metastases. 5'NT is specific to hepatobiliary disease, which can make it useful in conjunction with other liver enzyme activity assays, like gamma glutamyl transferase, to differentiate between an increase in alkaline phosphatase due to cholestatic liver disease rather than bone disease (Paget disease).
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.
<4.6 U/L
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Interpretation
Provides information to assist in interpretation of the test results
An elevation of 5'-nucleotidase (5'NT) activity may be seen in all forms of liver disease, although the highest elevations are seen in intra- or extra-hepatic biliary obstruction.
5'-nucelotidase may be more specific for intrahepatic cholestasis than gamma glutamyl transferase.
Elevation of 5'NT activity is not associated with skeletal disease. Thus, measurement of 5'NT in serum can be used to differentiate observed elevations of alkaline phosphatase due to skeletal disease vs. hepatobiliary disease.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Alkaline phosphatase (ALP) is known to cross-react with 5'-nucleotidase (5'NT) measurements. Placental ALP of 100 U/L gives a 5'NT result of 0.27 U/L. Accordingly, specimens with elevations of any ALP isoenzyme significantly above normal circulating activity must be interpreted cautiously.
5'-nucleotidase is neither specific nor sensitive enough to be used as a cancer screen.
Do not interpret serum 5' NT activity as absolute evidence of the presence or the absence of malignant disease. Use serum 5' NT in conjunction with information from the clinical evaluation of the patient and other diagnostic procedures.
Values obtained with different assay methods or kits may be different and cannot be used interchangeably.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Goldberg DM. 5'nucleotidase: recent advances in cell biology, methodology and clinical significance. Digestion. 1973;8(1):87-99
2. Drummond GI, Masanobu Y. Nucleotide Phosphomonoesterases. In: Boyer, P.D. ed. The Enzymes. Vol 4. 3rd ed., Academic Press; 1971:337-354
3. Kim NK, Yasmineh WG, Treier EF, Goldman A, Theologides A. Value of alkaline phosphatase, 5'-nucleotidase, gamma-glutamyltransferase, and glutamate dehydrogenase activity measurements (single and combined) in serum in diagnosis of metastasis to the liver. Clin Chem. 1977;23:2034-2038
4. van der Slik W, Persijn JP. Engelsman E, Riethorst A. Serum 5'-nucleotidase. Clin Biochem. 1970;3(1):59-80
5. Heinz F, Pilz R, Reckel S, Kalden JR, Haeckel RJ. A new spectrophotometric method for the determination of 5'-nucleotidase. J Clin Chem Clin Biochem. 1980;18(11):781-788
6. Bertrand A, Buret J. A one-step determination of serum 5'-nucleotidase using a centrifugal analyzer. Clin Chim Acta. 1982;119(3):275-284
7. Pincus MR, Carty RP. Clinical enzymology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2022:chap 21
8. Sapey T, Mendler MH, Guyader D, et al. Respective value of alkaline phosphatase, gamma-glutamyl transpeptidase and 5' nucleotidase serum activity in the diagnosis of cholestasis: a prospective study of 80 patients. J Clin Gastroenterol. 2000;30(3):259-263
9. Singh Gill, DMP. Comparative Study of serum gamma glutamyltransferase, 5' nucleotidase and alkaline phosphatase in icteric and an-icteric biliary disease patients. Int Med J Malays. 2013;12(1):59-62. doi.org/10.31436/imjm.v12i1.2004
10. Junna Z, Gongde C, Jinying X, Xiu Z. Serum AFU, 5'-NT and AFP as Biomarkers for Primary Hepatocellular Carcinoma Diagnosis. Open Med (Wars). 2017;12:354-358. doi:10.1515/med-2017-0051
Method Description
Describes how the test is performed and provides a method-specific reference
The Diazyme 5'-Nucleotidase (5'NT) assay is a coupled enzyme kinetic method where 5'NT facilitates the enzymatic hydrolysis of 5'-monophosphate to form inosine which is converted to hypoxanthine by purine nucleoside phosphorylase. Hypoxanthine is then converted to uric acid and hydrogen peroxide (H2O2) by xanthine oxidase. H2O2 is further reacted with N-Ethyl-N-(2-hydroxy-3-sulfopropyl)-3-methylaniline and 4-aminoantipyrine in the presence of peroxidase to generate quinone dye which is monitored in a kinetic manner and is proportional to the 5'NT activity which can be determined photometrically by an increase in absorbance at 550 nm compared to a calibration curve. One unit of 5'NT is defined as the amount of 5'NT that generates one micromole of inosine from IMP per min at 37 degrees C. Testing is performed utilizing a closed development channel on the Roche cobas c502 module on the cobas 8000 analyzer.(Package insert: 5'-Nucleotidase Assay. Diazyme Laboratories, Inc.; 05/2022)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
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 Saturday
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.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
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 account representative. 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. It 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.
CPT codes are provided by the performing laboratory.
83915
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| 5NTD | 5'-Nucleotidase, S | 1690-7 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 5NTD | 5'-Nucleotidase, S | 1690-7 |