• Test Code:
    7270
  • Department:
    Cancer FISH
  • Test Synonyms:
    Glioma FISH
  • CPT Code(s):
    88368x1 (FFPE Only)88369x3 (FFPE Only)
Background:

Gliomas may be divided into three major histologic types: astrocytomas, oligodendrogliomas and mixed oligoastrocytomas; subtyping, therapeutic regimen selection, and response to therapy may be addressed using FISH.  For instance: Loss of both 1p and 19q, or 19q solely, is strongly correlated with gliomas of oligodendroglial morphology and is infrequent in gliomas of astrocytic origin; Gain of 19q is associated with gliomas of astrocytic origin (Burton et al. 2002); PTEN deletions or monosomy 10 are often observed in malignant gliomas; EGFR expression (related to amplification) aids in tumor grading and may impact prognosis in conjunction with other markers.  FISH studies are useful adjuncts to complete chromosome studies, particularly when following an abnormal clone, assessing relapse and progression, or when material is inadequate for chromosomal analysis.
 
The Glioma FISH panel includes:
1) 1p36/1q25 probes, to detect deletion of chromosome 1p.
2) 19q13/19p13, to detect deletion of chromosome 19q or monosomy 19.
3) EGFR/CEP 7, to detect EGFR amplification.
4) PTEN/CEP 10, to detect deletion of chromosome 10q or monosomy 10.
 
Note:  Interphase FISH analysis is not intended to stand alone, but rather to provide supplemental information to routine cytogenetic studies.

Methodology:

Slides are prepared per standard protocols and 100-200 interphase cells are scored per probe
*Please note: it is our laboratory policy to analyze at least one metaphase cell from every hybridization, if possible, including both normal and abnormal cells, if both exist.

Specimen Requirements:

The Glioma FISH Panel can be performed on the following specimen types.  After collection, keep at room temperature until shipping.  Contact Client Services at (855) 535-1522 for shipping kits and instructions.
·         Fresh specimens of at least 1 cm3 (up to 3 inches in diameter): immediately collected with sterile methods into closable containers with transport medium. (Please contact Client Services to arrange for transport medium and shipping instructions).  Deliver the specimen in transport medium to the laboratory within a day, if possible, with decreased success rates as specimens are delayed in transit.  Protect sample from temperature extremes during shipping.

Sterile Ringer’s solution, either lactated or non-lactated and sterile isotonic saline are alternatives, if no complete RPMI is available.  Contact the lab for more information on media requirements. It is preferable to collect the specimen before initiation of chemotherapy in the patient.  Tumor samples should be selected from viable areas, with as little normal or necrotic material as possible.  Unacceptable specimens are acellular, necrotic specimens, septic specimens, specimens in fixative or frozen, or specimens collected more than one week previously.
 
·         FFPE slidesFFPE slides at room temperature. Preferred slice thickness is 5 micrometer on positively charged slides.  For focal tumors, an H&E stained slide should accompany the slides submitted for FISH.  Please submit 4-8 slides.  Contact Client Services with questions.
 
A REQUISTION FORM MUST ACCOMPANY ALL SAMPLES. Please include detailed clinical information.

Test Performed (Days):

Mon - Sat

Turn Around Time:

5–10 days Contact Lab at 855-KDL-1LAB (535-1522) - Time varies depending on number of tests performed.

Shipment Sensitivity Requirements:

  • Keep specimen at room temperature during transit. 
  • Do not use the cold pack provided in the KDL shipping kit. 
  • Ship the specimen overnight express, using the FedEx priority overnight label provided. 
  • The specimen must arrive at the lab no more than 24 hours after collection.

References:

Additional Info: