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HelpOrder Code MGMT MGMT Promoter Methylation, Tumor
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
VariesNecessary 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.
Specimen 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.
Method Description
A real-time methylation-specific polymerase chain reaction assay that evaluates 8 CpG sites (79-86) within the downstream differentially methylated region of the MGMT promoter region.(Ida CM, Butz ML, Jenkins RB, et al. Real-time methylation-specific polymerase chain reaction for MGMT promoter methylation clinical testing in glioblastoma: An alternative detection method for a heterogeneous process. Am J Clin Pathol. 2017;148[4]:296-307)
Day(s) Performed
Varies
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81287
88381
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.