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HelpTest Code MGMT MGMT Promoter Methylation, Tumor
Necessary Information
Pathology report (final or preliminary), at minimum containing the following information, must accompany specimen for testing to be performed:
1. Patient name
2. Block number-must be on all blocks, slides, and paperwork (can be handwritten on the paperwork)
3. Tissue collection date
4. Source of the tissue
Specimen Required
Preferred:
Specimen Type: Tissue
Container/Tube: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block. At least 40% tumor is required for this assay. In general, a 6 mm x 3 mm area of tissue cut at 5-micron thickness is the minimum amount of tissue needed; this could be collected over multiple slides.
Acceptable:
Specimen Type: Tissue sections
Slides: 1 Stained and 5 unstained
Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 5 unstained, nonbaked slides with 5-micron thick sections of the tumor. At least 40% tumor is required for this assay. In general, a 6 mm x 3 mm area of tissue cut at 5-micron thickness is the minimum amount of tissue needed; this could be collected over multiple slides.
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
Useful For
Prognostication of newly diagnosed patients with glioblastoma, IDH-wildtype
Identifying newly diagnosed glioblastoma, IDH-wildtype patients that may respond to alkylating chemotherapy (ie, temozolomide)
Guiding therapy decision making for newly diagnosed glioblastoma, IDH-wildtype in older patients (>60-65 years)
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SLIRV | Slide Review in MG | No, (Bill Only) | Yes |
Testing Algorithm
When this test is ordered, slide review will always be performed at an additional charge.
Method Name
Methylation-Specific Polymerase Chain Reaction (PCR) Analysis
Reporting Name
MGMT Promoter Methylation, TumorSpecimen Type
VariesSpecimen Minimum Volume
5 Unstained slides at 5-microns thickness
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Frozen | |||
| Refrigerated | |||
Reject Due To
| Specimens that have been decalcified (all methods) Specimens that have not been formalin-fixed, paraffin-embedded Bone marrow in EDTA |
Reject |
Reference Values
An interpretive report will be provided.
Day(s) Performed
Varies
Report Available
7 to 10 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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.CPT Code Information
81287
88381
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MGMT | MGMT Promoter Methylation, Tumor | 60252-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 36734 | Result Summary | 50397-9 |
| 36735 | Result | 60252-4 |
| 36736 | Interpretation | 69047-9 |
| 36737 | Additional Information | 48767-8 |
| 36738 | Specimen | 31208-2 |
| 36739 | Source | 31208-2 |
| 36740 | Tissue ID | 80398-1 |
| 36741 | Released by | 18771-6 |