ARUP's Laboratory Test Directory

Familial Adenomatous Polyposis (APC) Deletion/Duplication : 2004920
[ image for: Patient History for Familial Adenomatous Polyposis Testing]
Patient History for Familial Adenomatous Polyposis Testing
  


Mnemonic: APC DELDUP

Ordering Recommendation: Diagnostic testing for familial adenomatous polyposis. Predictive testing for familial adenomatous polyposis.
Methodology: Polymerase Chain Reaction/Multiplex Ligation-dependent Probe Amplification
Performed: Varies
Reported: Within 14 days
Specimen Required: Collect: Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).

Specimen Preparation: Transport 3 mL whole blood. (Min: 1 mL)

Storage/Transport Temperature: Refrigerated.

Stability (collection to initiation of testing): Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable
Interpretive Data: Background Information for Familial Adenomatous Polyposis (APC) Deletion/Duplication:
Characteristics of APC-associated Polyposis:
Familial Adenomatous Polyposis (FAP): Development of hundreds to thousands of adenomatous colonic polyps beginning in early adolescence; lifetime risk for cancer is 100 percent. Additional findings may include dental anomalies, polyps of the gastric fundus and duodenum, and congenital hypertrophy of the retinal pigment epithelium (CHRPE).
Attenuated FAP: Fewer colonic adenomatous polyps (average of 30), which are more proximally located and cancer generally occurs at a later age; lifetime risk for cancer is 70 percent.
Gardner syndrome: Multiple colonic adenomatous polyps along with osteomas, desmoid tumors, and soft tissue tumors.
Incidence: Less than 1 percent of colorectal cancer cases.
Inheritance: Autosomal dominant.
Penetrance: Greater than 99 percent in untreated individuals with classic FAP.
Cause: Pathogenic APC mutations.
Clinical Sensitivity: Approximately 8-12 percent for classic FAP.
Methodology: Multiplex ligation-dependent probe amplification (MLPA) to detect large APC coding region deletions and duplications.
Analytical Sensitivity and Specificity of MLPA: 99 percent.
Limitations: Rare diagnostic errors can occur due to probe site mutations. Single base pair substitutions, small deletions/duplications, regulatory region mutations, and deep intronic mutations will not be detected. Deletion/duplication breakpoints will not be determined. Mutations in genes other than APC will not be detected.



Counseling and informed consent are recommended for genetic testing. Consent forms are available online at www.aruplab.com.

See Compliance Statement C: www.aruplab.com/CS
CPT Code(s): 81203
Cross References: APC-Associated Polyposis (Familial Adenomatous Polyposis (APC) Deletion/Duplication) , Attenuated FAP (Familial Adenomatous Polyposis (APC) Deletion/Duplication) , Gardner Syndrome (Familial Adenomatous Polyposis (APC) Deletion/Duplication) , Turcot Syndrome (Familial Adenomatous Polyposis (APC) Deletion/Duplication)