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Test Code EGFRW EGFR Targeted Mutation Analysis with ALK Reflex, Tumor


Necessary Information


A pathology report must accompany specimen for testing to be performed.



Specimen Required


Preferred: Submit both of the following specimens.

Acceptable: Submit at least one of the following specimens.

 

Specimen Type: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block with acceptable amount of tumor tissue.

 

Specimen Type: Tissue slide

Slides: 1 Hematoxylin and eosin-stained and 10 unstained

Collection Instructions:

Collection Instructions:

Submit the followings slides:

1 Slide stained with hematoxylin and eosin

AND

10 Unstained, nonbaked slides with 5-micron thick sections of the tumor tissue.

Note: The total amount of required tumor nuclei can be obtained by scraping up to 10 slides from the same block.

Additional Information: Unused unstained slides will not be returned.


Forms

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

Molecular Genetics: Inherited Cancer Syndromes Patient Information (T519)

Oncology Test Request (T729)

Useful For

Identifying non-small cell lung cancers that may benefit from treatment with epidermal growth factor receptor -targeted therapies or anaplastic lymphoma kinase inhibitors

Additional Tests

Test ID Reporting Name Available Separately Always Performed
SLIRV Slide Review in MG No, (Bill Only) Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
LCAF ALK (2p23), Lung Cancer, FISH, Ts Yes No

Testing Algorithm

When this test is ordered, the EGFR Gene, Mutation Analysis, 51 Mutation Panel, Tumor will always be performed. All specimens without an EGFR mutation will be automatically reflexed to testing for the ALK (2p23) rearrangement. Specimens with an identified EGFR mutation will result in cancellation of the reflex test.

 

When this test is ordered, a slide review will always be performed at an additional charge.

Method Name

Polymerase Chain Reaction (PCR)

Reporting Name

EGFR with ALK Reflex, Tumor

Specimen Type

Varies

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Reference Values

An interpretive report will be provided.

Day(s) Performed

Monday through Friday

Report Available

5 to 14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

81235-EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants(eg, exon 19 deletions, L858R, T790M, G719S, L861Q)

88381-Microdissection, manual

88271 x 2-DNA Probe (if appropriate)

88274-Interphase in situ hybridization (if appropriate)

88291-Interpretation and report (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EGFRW EGFR with ALK Reflex, Tumor 21665-5

 

Result ID Test Result Name Result LOINC Value
616130 Result Summary 50397-9
616131 Result 21665-5
616132 Interpretation 69047-9
616133 Specimen 31208-2
616134 Source 31208-2
616135 Tissue ID 80398-1
616136 Released By 18771-6

Test Classification

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.