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HelpTest Code IDHT IDH1 and IDH2 Mutation Analyses, Next-Generation Sequencing, Tumor
Ordering Guidance
If this test is ordered with TERTD / TERT Promoter Mutation Analysis, Droplet Digital PCR, Tumor, this test will be canceled and IDTRT / IDH1, IDH2, and TERT Mutation Analysis, Next-Generation Sequencing, Tumor will be ordered.
Multiple oncology (cancer) gene panels are available. For more information see Hematology, Oncology, and Hereditary Test Selection Guide.
Necessary Information
A 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
This assay requires at least 20% tumor nuclei.
-Preferred amount of tumor area with sufficient percent tumor nuclei: tissue 216 mm(2)
-Minimum amount of tumor area: tissue 36 mm(2)
-These amounts are cumulative over up to 10 unstained slides and must have adequate percent tumor nuclei.
-Tissue fixation: 10% neutral buffered formalin, not decalcified
-For specimen preparation guidance, see Tissue Requirements for Solid Tumor Next-Generation Sequencing. In this document, the sizes are given as 4 mm x 4 mm x 10 slides as preferred: approximate/equivalent to 144 mm(2) and the minimum as 3 mm x 1 mm x 10 slides: approximate/equivalent to 36 mm(2).
Preferred:
Specimen Type: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block with acceptable amount of tumor tissue.
Acceptable:
Specimen Type: Tissue slides
Slides: 1 Stained and 10 unstained
Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, nonbaked slides wit 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.
Specimen Type: Cytology slides (direct smears or ThinPrep)
Slides: 1 to 3 Slides
Collection Instructions: Submit 1 to 3 slides stained and coverslipped with a preferred total of 5000 nucleated cells, or a minimum of at least 3000 nucleated cells.
Note: Glass coverslips are preferred; plastic coverslips are acceptable but will result in longer turnaround times.
Additional Information: Cytology slides will not be returned.
Secondary ID
616498Useful For
Identifying specific mutations within the IDH1 and IDH2 genes that assist in tumor diagnosis/classification and predict response to targeted therapy
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.
Special Instructions
Method Name
Sequence Capture and Targeted Next-Generation Sequencing (NGS)
Reporting Name
IDH1/IDH2 Mutations Analysis, TumorSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Reject Due To
| Specimens that have been decalcified (all methods) Specimens that have not been formalin-fixed, paraffin-embedded, except for cytology slides Extracted nucleic acid (DNA/RNA) |
Reject |
Clinical Information
IDH1 and IDH2 (isocitrate dehydrogenase: IDH) genes encode enzymes involved in cellular glucose metabolism. Mutations in the IDH genes primarily involve codons R132 in IDH1 and R140 and R172 in IDH2 and lead to the neomorphic ability to generate oncometabolite R(-)-2-hydroxyglutarate, which contributes to tumorigenesis. In central nervous system (CNS) tumors, IDH mutations are a diagnostic molecular biomarker for diffuse gliomas and define two biologically distinct groups: IDH-mutant and IDH-wildtype tumors. IDH mutations are rarely observed in other CNS tumor types and are not seen in CNS reactive non-neoplastic processes. IDH mutations are also a molecular biomarker in non-CNS tumors, including acute myeloid leukemia, cholangiocarcinoma, and cartilaginous tumors. Clinically approved targeted therapies are available for a subset of patients with IDH-mutant acute myeloid leukemia and IDH-mutant cholangiocarcinoma.
Reference Values
An interpretive report will be provided.
Interpretation
The interpretation of molecular biomarker analysis includes an overview of the results and the associated diagnostic, prognostic, and therapeutic implications.
Method Description
Next-generation sequencing is performed to evaluate the presence of a mutation in all coding regions of the IDH1 and IDH2 genes. See Targeted Genes and Methodology Details for IDH1/IDH2 Mutation Analysis for details regarding the targeted gene regions evaluated by this test. (Unpublished Mayo method)
A pathology review and macro dissection to enrich for tumor cells is performed prior to slide scraping.
Day(s) Performed
Monday through Friday
Performing 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
88381-Microdissection, manual
81479
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| IDHT | IDH1/IDH2 Mutations Analysis, Tumor | 104323-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 617913 | Result | 82939-0 |
| 617914 | Interpretation | 69047-9 |
| 617915 | Additional Information | 48767-8 |
| 617916 | Specimen | 31208-2 |
| 617917 | Tissue ID | 80398-1 |
| 617918 | Method | 85069-3 |
| 617919 | Disclaimer | 62364-5 |
| 617920 | Released By | 18771-6 |
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.