Test Catalog

Test Id : HPP

Pancreatic Polypeptide, Plasma

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

Detection of pancreatic endocrine tumors

 

Assessment of vagal nerve function after meal or sham feeding

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

Radioimmunoassay (RIA)

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

Pancreatic Polypeptide, P

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

HPP (Human Pancreatic Polypeptide)

Human Pancreatic Polypeptide

PP (Pancreatic Polypeptide,Plasma)

Specimen Type
Describes the specimen type validated for testing

Plasma EDTA

Ordering Guidance

This test should not be requested on patients who have recently received radioactive materials.

Necessary Information

Patient's age must be provided.

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

Patient Preparation: Fasting (8 hours)

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 3 mL

Collection Instructions:

1. Place specimen on wet ice and keep cold at all times following collection.

2. Centrifuge (refrigerated centrifuge is not required) and aliquot plasma into plastic vial. Freeze immediately.

Forms

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.35 mL

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

Gross hemolysis Reject
Gross lipemia Reject
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
Plasma EDTA Frozen (preferred) 90 days

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

Detection of pancreatic endocrine tumors

 

Assessment of vagal nerve function after meal or sham feeding

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

Pancreatic polypeptide (PP) is secreted by the pancreas in response to hypoglycemia, ingestion of food, or "sham" feeding (food is chewed, but not swallowed) secondary to vagal nerve stimulation. Secretion is blocked by vagotomy or atropine.

 

The exact physiologic role of PP is undetermined, although the hormone is thought to be involved in exocrine pancreatic secretion and gallbladder emptying.

 

Markedly elevated levels are often associated with endocrine tumors of the pancreas (eg, insulinoma, glucagonoma, PPoma: pancreatic polypeptide-secreting tumor of the pancreas) Patients with diabetes may also have elevated PP levels.

 

A lack of response to sham feeding may indicate vagal nerve damage (eg, surgery-related nerve damage, autonomic nerve disorders). Extensive pancreatic destruction (eg, chronic pancreatitis, pancreatic cancer) may also result in low basal PP levels and a lack of response to sham feeding.

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.

0-19 years: not established

20-29 years: <228 pg/mL

30-39 years: <249 pg/mL

40-49 years: <270 pg/mL

50-59 years: <291 pg/mL

60-69 years: <312 pg/mL

70-79 years: <332 pg/mL

> or =80 years: not established

Interpretation
Provides information to assist in interpretation of the test results

High levels may be seen in pancreatic endocrine tumors, diabetes, and a nonfasting state. Markedly elevated levels may be seen in some pancreatic exocrine tumors.

 

A normal response to a sham feeding consists of a rapid pancreatic polypeptide (PP) rise over baseline followed by a return to baseline. With vagal damage, no increase over baseline is seen.

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

Pancreatic polypeptide (PP) normal values increase with age (approximately 20 pg/mL per decade).

 

Nonfasting state results in falsely elevated values.

 

The sham feeding test is invalid if food is swallowed. Ingestion of food typically results in a significant and prolonged PP increase over baseline (typically >200 pg/mL).

 

This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. A recommended time period before collection cannot be made because it will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held and assayed after the radioactivity has sufficiently decayed. This will result in a test delay.

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

1. Panzuto F, Severi C, Cannizzaro R, et al: Utility of combined use of plasma levels of chromogranin A and pancreatic polypeptide in the diagnosis of gastrointestinal and pancreatic endocrine tumors. J Endocrinol Invest 2004 Jan;27(1):6-11

2. Brimnes Damholt M, Rasmussen BK, Hilsted L, et al: Basal serum pancreatic polypeptide is dependent on age and gender in an adult population. Scand J Clin Lab Invest 1997 Dec;57(8):695-702

3. Escobar H, Jushnir M, Ray J, et al: A Measurement of Pancreatic Polypeptide and its Peptide Variant in Human Serum and Plasma by Immunocapture-Liquid-Chromatography-Tandem Mass Spectrometry. Reference Intervals and Practical Assay Considerations. Biochem Physiol 2014 Aug;3:4

4. Balaji N, Crookes P, Banki F, et al: A Safe and Noninvasive Test for Vagal Integrity Revisited. Arch Surg 2002;137:954-959

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

A radioimmunoassay technique is used. The assay system utilizes rabbit-antihuman pancreatic polypeptide (PP) antiserum, a standard or patient plasma specimen, and radiolabeled human PP that has been iodinated by a modified Hunter-Greenwood technique.(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.

Sunday, Tuesday

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 8 days

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

3 months

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.

83519

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
HPP Pancreatic Polypeptide, P 2721-9
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.
8014 Pancreatic Polypeptide, P 2721-9

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