Test ID: HPP
Pancreatic Polypeptide, Plasma
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
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)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Human Pancreatic Polypeptide
PP (Pancreatic Polypeptide,Plasma)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 3 mL
Collection Instructions:
1. Fasting (8 hours)
2. Specimen must be kept cold at all times following draw.
3. Refrigerated centrifuge is not required.
Additional Information: Include patient's age.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild OK; Gross reject |
| Lipemia | Mild reject; Gross reject |
| Icterus | Mild OK; Gross OK |
| Other | Plasma separator tube |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma EDTA | Frozen | 90 days |
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). 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 nonfasting state. Markedly elevated levels may be seen in some pancreatic exocrine tumors.
A normal response to a sham feeding consists of a rapid 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 Provides recommendations for further in-depth reading of a clinical nature
1. Schwartz TW: Pancreatic polypeptide: a hormone under vagal control. Gastroenterology 1983;85:1411-1425
2. Koch MB, Go VL, DiMagno EP: Can plasma human pancreatic polypeptide be used to detect disease of the exocrine pancreas? Mayo Clin Proc 1985;60:259-265
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 which has been iodinated by a modified Hunter-Greenwood technique. (Koch MB, Go VL, DiMagno EP: Can plasma human pancreatic polypeptide be used to detect disease of the exocrine pancreas? Mayo Clin Proc 1985;60:259-265)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday, Wednesday; 1 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
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 The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83519
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 8014 | Pancreatic Polypeptide, P | 2721-9 |
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