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24817 Pancreatic Polypeptide, Plasma (HPP)

Pancreatic Polypeptide, Plasma (HPP)
Test Code: HPPSO
Synonyms/Keywords
​HPP (Human Pancreatic Polypeptide), Human Pancreatic Polypeptide, PP (Pancreatic Polypeptide,Plasma)
Useful For
Detection of pancreatic endocrine tumors
 
Assessment of vagal nerve function after meal or sham feeding​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Yes (8 hours) Plasma EDTA​ ​EDTA Lavender Top Tube (LTT) ​ ​3 mL ​0.35 mL ​
Collection Processing Instructions
This test should not be requested on patients who have recently received radioactive materials

1. Fasting (8 hours)
2. Place specimen on wet ice and keep cold at all times following collection.
3. Centrifuge (refrigerated centrifuge is not required) and aliqout plasma into plastic vial. Freeze immediately.
 
Additional Information: Include patient's age.
Specimen Stability Information
Specimen Type Temperature Time
​Plasma EDTA ​Frozen ​90 days
Rejection Criteria
Hemolysis Gross
​Lipemia Gross
Interference

​​Pancreatic polypeptide (PP) normal values increase with age (approximately 20 pg/mL per decade).​

Nonfasting state results in falsely elevated values.

The sham feeding test is invalid if food is swallowed. Ingestion of food typically results in a significant and prolonged PP increase over baseline (typically >200 pg/mL).

This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. A recommended time period before collection cannot be made because it will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held and assayed after the radioactivity has sufficiently decayed. This will result in a test delay.

Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available
 Methodology/Instrumentation
​Mayo Clinic Laboratories Monday, Wednesday​ ​4 to 8 days
Radioimmunoassay (RIA)​
Reference Lab
Mayo Clinic Laboratories
Test Information
Pancreatic polypeptide (PP) is secreted by the pancreas in response to hypoglycemia, ingestion of food, or "sham" feeding (food is chewed, but not swallowed) secondary to vagal nerve stimulation. Secretion is blocked by vagotomy or atropine.
 
The exact physiologic role of PP is undetermined, although the hormone is thought to be involved in exocrine pancreatic secretion and gallbladder emptying.
 
Markedly elevated levels are often associated with endocrine tumors of the pancreas (eg, insulinoma, glucagonoma, pancreatic polypeptide-secreting tumor of the pancreas). Patients with diabetes may also have elevated PP levels.
 
A lack of response to sham feeding may indicate vagal nerve damage (eg, surgery-related nerve damage, autonomic nerve disorders). Extensive pancreatic destruction (eg, chronic pancreatitis, pancreatic cancer) may also result in low basal PP levels and a lack of response to sham feeding.​
Reference Range Information
0-19 years: not established
20-29 years: <228 pg/mL
30-39 years: <249 pg/mL
40-49 years: <270 pg/mL
50-59 years: <291 pg/mL
60-69 years: <312 pg/mL
70-79 years: <332 pg/mL
> or =80 years: not established
Interpretation
High levels of pancreatic polypeptide may be seen in pancreatic endocrine tumors, diabetes, and a nonfasting state. Markedly elevated levels may be seen in some pancreatic exocrine tumors.​
 
A normal response to a sham feeding consists of a rapid PP rise over baseline followed by a return to baseline. With vagal damage, no increase over baseline is seen.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83519 ​ ​ ​ ​
Synonyms/Keywords
​HPP (Human Pancreatic Polypeptide), Human Pancreatic Polypeptide, PP (Pancreatic Polypeptide,Plasma)
Ordering Applications
Ordering Application Description
​Cerner ​Pancreatic Polypeptide, Plasma (HPP)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Yes (8 hours) Plasma EDTA​ ​EDTA Lavender Top Tube (LTT) ​ ​3 mL ​0.35 mL ​
Collection Processing
This test should not be requested on patients who have recently received radioactive materials

1. Fasting (8 hours)
2. Place specimen on wet ice and keep cold at all times following collection.
3. Centrifuge (refrigerated centrifuge is not required) and aliqout plasma into plastic vial. Freeze immediately.
 
Additional Information: Include patient's age.
Specimen Stability Information
Specimen Type Temperature Time
​Plasma EDTA ​Frozen ​90 days
Rejection Criteria
Hemolysis Gross
​Lipemia Gross
Interference

​​Pancreatic polypeptide (PP) normal values increase with age (approximately 20 pg/mL per decade).​

Nonfasting state results in falsely elevated values.

The sham feeding test is invalid if food is swallowed. Ingestion of food typically results in a significant and prolonged PP increase over baseline (typically >200 pg/mL).

This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. A recommended time period before collection cannot be made because it will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held and assayed after the radioactivity has sufficiently decayed. This will result in a test delay.

Useful For
Detection of pancreatic endocrine tumors
 
Assessment of vagal nerve function after meal or sham feeding​
Reference Range Information
0-19 years: not established
20-29 years: <228 pg/mL
30-39 years: <249 pg/mL
40-49 years: <270 pg/mL
50-59 years: <291 pg/mL
60-69 years: <312 pg/mL
70-79 years: <332 pg/mL
> or =80 years: not established
Interpretation
High levels of pancreatic polypeptide may be seen in pancreatic endocrine tumors, diabetes, and a nonfasting state. Markedly elevated levels may be seen in some pancreatic exocrine tumors.​
 
A normal response to a sham feeding consists of a rapid PP rise over baseline followed by a return to baseline. With vagal damage, no increase over baseline is seen.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available
 Methodology/Instrumentation
​Mayo Clinic Laboratories Monday, Wednesday​ ​4 to 8 days
Radioimmunoassay (RIA)​
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83519 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.