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Neurology

Advanced Technology Laboratory, Molecular Diagnostics

NTRK on Track

NTRK Gene Fusion is Available at Corewell Health West Molecular Diagnostics Laboratory

NTRK genes (NTRK1, NTRK2, NTRK3) encode tropomyosin receptor kinases (TRK) family of tyrosine protein kinase receptors TRK A, B and C. Trk receptors are composed of extracellular domain regulated by neurotrophins, and intracellular tyrosine kinase domain that activates downstream signaling. Trk receptors play essential roles in the development and maintenance of nervous system. NTRK gene fusion events join the catalytic tyrosine kinase domain of the TRK protein with the dimerization domain of fusion partner to confer ligand-independent downstream signaling which may promote cancer cells to grow.

NTRK Gene Fusion by Archer® FusionPlex platform can detect RNA transcripts of NTRK1/2/3 gene fusion with any partner genes. TRK inhibitors treatment may be considered in patients with NTRK gene fusion positive disease for various types of pediatric and adult cancers.

RNA-based sequencing is the most reliable method for NTRK gene fusion detection. Immunohistochemistry by pan-TRK antibody can provide fast screening for tumors with positive TRK expression. However, RNA based molecular testing is necessary to confirm the presence of true NTRK Gene Fusion event.

Please direct questions and inquiries to the Contact Us link above

 

TEST INFORMATION

NTRK Gene Fusion, Epic order code: LAB1230897, CPT 81194

March 23, 2023 by
Toxicology

Update to Vitamin D Testing

Effective February 28th, 2023, Vitamin D 25-Hydroxy Level (25-OH Vitamin D) [LAB535] will be replaced by 25-Hydroxyvitamin Level D2 and D3 [LAB1230925]. Send out testing for 25-Hydroxyvitamin D2 and D3, Serum [LAB1230428] to Mayo will be discontinued. The testing methodology will change from an immunoassay to liquid chromatography-mass spectrometry.

The new test will include concentrations for

  • 25-hydroxyvitamin D2
  • 25-hydroxyvitamin D3
  • 25-hydroxyvitamin D Total

Continue Reading

February 22, 2023 by
General Information

Albumin Testing Update

Albumin Reagent Conversion

Corewell Health Laboratories (formerly Spectrum Health) has utilized the Bromcresol Purple (BCP) method for the measurement of albumin concentration in serum, plasma, and serous body fluids for well over 20 years. The test principle consists of a reaction where the BCP binds selectively with albumin, causing a color change that is measured photometrically. A vast majority of labs across the country, including reference labs such as Mayo Medical Laboratories, utilize an alternative method for albumin measurement that consists of Bromcresol Green (BCG) instead of BCP. To align with the majority of institutions this size, and to be included in a larger peer group for proficiency testing purposes, Corewell Health Laboratories – West, has been transitioning to BCG for the measurement of albumin over the last few weeks. Continue Reading

January 26, 2023 by
Chemistry, Test Spotlight

Reminder: Folate Test and Fasting

Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting.  Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.

Spectrum Health Laboratories recommends:

• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.

• Take normal dosages of medications unless the provider has instructed otherwise.

Click here for a list of tests the require or recommend fasting. Continue Reading

March 31, 2022 by
General Information, Hematology

Test Update: Cell Count with Differential, Body Fluid

Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids.   This component will be displayed in Epic as an absolute PMN count, body fluid.

• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.

• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).

• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).

• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.

• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS Continue Reading

December 28, 2021 by
General Information, Immunochemistry, Test Utilization

Protein Electrophoresis Orderable Changes

As of August 26, 2020, the following tests will be obsoleted or made as lab orderables only.  This was implemented to streamline protein electrophoresis orders and ensure that patients receive the recommended testing for the assessment of plasma cell proliferative diseases.

In addition to streamlining protein electrophoresis orders, order questions have been implemented to the available tests to access the reason for ordering to ensure that the proper reflex testing is applied.

For more information, see the lab test directory under the available tests for a protein electrophoresis orders tip sheet entitled “Orders- Protein Orderable Changes” Continue Reading

September 23, 2020 by
General Information, Immunochemistry

Immunochemistry Methodology Update

Effective December 11th, 2019, Spectrum Health Regional Laboratory’s Immunochemistry laboratory will be upgrading the following tests from the Immunoassay Vidas platform to the Multiplex flow immunoassay Bioplex 2200 platform.

Cytomegalovirus IgG Antibody

Cytomegalovirus IgM Antibody

Toxoplasma IgG Antibody

Toxoplasma IgM Antibody

Lyme Total Antibody

All tests will continue to have the same collection instructions, processing instructions, rejection criteria, specimen stability, turn-around-time, and qualitative reference ranges of negative. Continue Reading

December 2, 2019 by
General Information, Immunochemistry

Test Update: Beta-2 Glycoprotein 1 Antibodies

Effective November 5th, testing for Beta-2 Glycoprotein 1 antibodies (IgG and IgM, serum) will change from a reference send out test to Mayo Medical Laboratories to an in-house test available at Spectrum Health Laboratories.  This testing is useful for evaluation of patients of suspected antiphospholipid antibody syndrome.

In addition, a new Antiphospholipid Antibody Syndrome Panel will be added which allows for appropriate and complete testing for antiphospholipid antibody syndrome. This panel includes:

Lupus Screen

Cardiolipin IgG and IgM Antibodies

Beta-2 Glycoprotein 1 IgG and IgM Antibodies

Continue Reading

November 4, 2019 by