Laboratory Test Preparation

Phosphoinositide 3-Kinase

Not applicable

Used for the qualitative detection and identification of mutations in exons 1, 4, 7, 9 and 20 of the Phosphatidylinositol- 3-kinase catalytic subunit alpha isoform (PI3KCA) gene in DNA derived from formalin-fixed paraffin-embedded tissue (FFPET).

Polymerase Chain Reaction / Sequencing

Special Test

No patient preparation necessary.

Slide holders or mailers for microscope slides; FFPE tissue blocks can either be wrapped in paper or placed in a box.

• Formalin-fixed paraffin-embedded (FFPE) tissue block
• 1 H&E stained slide representative of the submitted tissue block.
• Histopathology report for the submitted tissue block

Not Applicable

Indefinite

Not applicable

Not applicable

• Microscope slides should be placed in slide holders or mailers and should be adequately padded before placing in a shipping/packaging container to prevent breakage.
• FFPE tissue blocks must be placed in a box and avoid direct sunlight to prevent melting and disorientation during transport or shipping.
• Transport specimen at 15°C ~25 °C (room temperature)

• Incomplete information in the Request Form
• Improper or insufficient labeling of tissue blocks or slides
• Inadequate tissue available on the tissue block

Batch Running

Monday, 12:00 PM

14 days after cut off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None specified.

Not applicable

Phosphoinositide 3-Kinase, brain tumor

• Protein Induced Vitamin K Absence or Antagonist II
• DCP
• Des-gamma-carboxy prothrombin

Not Applicable

Aids in the diagnosis and prognosis of patients with Hepatocellular carcinoma (HCC) and in monitoring HCC patients under therapy.

Note: The measured PIVKA (DCP) value of a patient’s sample can vary depending on the testing procedure used. PIVKA (DCP) values determined on patient samples using different testing procedures cannot be directly compared with one another. In monitoring patients’ result, it is recommended that the same testing method shall be used.

Isotachophoresis with Laser-Induced Fluorescence

Immunology

No patient preparation necessary.

Note:

Vitamin K administration may result in reduced PIVKA II concentration in the specimen.

Administration of Vitamin K antagonist (Warfarin) or antibiotic may result in elevated PIVKA II in the specimen.

Red or Gold tube

1-3 mL of Serum

Not applicable

Note Specified

7 Days

3 weeks

Transport specimen at 2°C – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic sample
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Wrong collection tube used

Saturday

Monday to Saturday: 6 PM

 

• : ROUTINE (on running days)
  • 4 hours after receipt of specimen/ arrival of messenger
   

PIVKA-II:  <40.00 mAU/mL

• Specimens from patients who have received preparations of mouse monoclonal antibodies for diagnosis or therapy may contain human anti-mouse antibodies (HAMA). Such specimens may show either falsely elevated or depressed values.
• Heterophilic antibodies in human serum can react with reagent immunoglobulins, interfering with in vitro immunoassays.
• Medications containing Vitamin K analogs may cause a negative bias on the Des-gamma-carboxy prothrombin (PIVKA-II) values.
• PIVKA-II values may show a positive bias when patients are receiving antimicrobial drugs, vitamin K antagonists, a diet low in vitamin K, or patients with alcoholic liver disease who are consuming alcohol.
• Vitamin K administration may result in reduced PIVKA II concentration in the specimen.
• Administration of Vitamin K  antgonist (Warfarin) or antibiotic may result in elevated PIVKA II in the specimen.
• PIVKA (DCP) producing tumors other than HCC can show elevated values of PIVKA-II (DCP).

Q: If I have liver cancer in my family, should I be tested for PIVKA II?
A: PIVKA II is not intended to be used to screen the general population or those who are healthy. A PIVKA II test may be occasionally performed if you have chronic liver disease and your healthcare practitioner wants the additional information it may offer.

Q: If I have hepatitis, should I have a PIVKA II test performed?
A: You should talk to your healthcare practitioner. Guidelines by the American Association for the Study of Liver Diseases (AASLD) do not recommend using PIVKA II as a screening test for the development of HCC, but it is used for this purpose in some other parts of the world.

Q: Why Get Tested?
A: To evaluate effectiveness of treatment for hepatocellular carcinoma (HCC), a type of liver cancer, if the level of  PIVKA II  is elevated prior to treatment; to monitor for recurrence of HCC

Q: When to Get Tested?
A: Periodically when you have been treated for HCC

CEA, CA-125, hCG, Tumor Marker,  HCC, Hepatocellular Carcinoma

Not Applicable

Not Applicable

ThePLAC testis a bloodtestused to measure serum activity of lipoprotein-associated phospholipase A₂(Lp-PLA₂), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall.

Special Test

No patient preparation necessary.

Red or Gold Tube

5 ML Serum

Not Applicable

24 Hours

14 Days

28 Days

Transport specimen at 2°C - 8°C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Thursday

Wednesday 7:00 AM

3 days after running day (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified

Not Applicable

Not Applicable

Platelet Antibody Indirect,Anti-Platelet Antibodies

• Plt Ab:GP IIb/IIIa
• Plt Ab:GP Ia/IIa
• Plt Ab:GP Ib/IX
• Plt Ab:GP IV
• Plt Ab:HLA Class I

Platelet Antibody Screen (Indirect) - Assay detects platelet IgG/A/M antibodies in serum.

Enzyme Linked Immunosorbent Assay (ELISA)

Special test

Serum that cannot be tested immediately should be frozen as soon as possible. Please spin down whole blood specimens and pour off serum and transport frozen.

Red tube only (No gel Separator)

3mL Serum

Not applicable

Unacceptable

Unacceptable

30 Days

Transport with dry ice

Gross hemolysis • Grossly lipemic • Serum Separator Tube (SST®) • Clotted • Grossly icteric • Plasma

Batch Running

Monday, 12:00 PM

14 days after cut-off (excluding saturdays, Sundays and Holidays)

• Actual Platelet Count (APC)
• Thrombocyte Count
• PLT                                                                                                                               •Platelet Distribution Width                                                                                                     •PDW                                                                                                                                            •Mean Platelet Volume                                                                                                      •MPV

Not applicable

• Part of Complete Blood Count that help assess patient's general health status
• Generally monitored when patient is with fever

• Fluorescence Cytometry & Hydrodynamic Focusing

Hematology

No patient preparation necessary.

EDTA (purple top)

• 2mL EDTA whole blood
Note: 0.250- 0.500 mL EDTA whole blood if microtainer is used

Not applicable

4 Hours

24 Hours

Not applicable

Transport specimen at 2 – 10 °C (with cold packs)

• Improperly labeled specimens
• Clotted specimens
• Over-filled or Under-filled tube
• Quantity not sufficient
• Specimen stored and transported outside the required temperature

Daily

Monday to Saturday
• 8:00 PM

Sunday
• 3:00 PM

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• After 1½ HOURS from extraction/messenger arrival

Available upon request.

• Cold agglutinins
• Microcytosis
• Anisocytosis

Not applicable

Complete Blood Count, CBC, Platelet Function Tests, Blood Smear, Von Willebrand Factor, Heparin-induced Thrombocytopenia PF4 Antibody, Coagulation Factors, Prothrombin Time and International  Normalized Ratio (PT/INR), Partial Thromboplastin Time (PTT, aPTT), JAK2Mutation, Low platelets, Bleeding Disorders, Anemia, Myeloproliferative Neoplasms, Disseminated Intravascular Coagulation  (DIC), Leukemia, Lymphoma, Autoimmune Disease, Sepsis.

Not applicable

1. Macroscopic
2. Microscopic
3. Differential Count
4. Pleural Fluid Glucose
5. Pleural Fluid Protein

• Cell Count and Differential Count: Cell count and identification of types of cells present are used in determining the cause of an effusion, especially when used in combination with an individual's medical history, physical examination and other tests performed.
• Body Fluid Protein and Glucose: Differentiates Transudates from Exudates. It helps identify the cause of fluid accumulation.

• WBC count- Fluorescent Cytometry
• RBC count- Hydrodynamic Focusing
• Differential Count- Fluorescence Cytometry/ Microscopic Examination
• Body Fluid Protein - Colorimetric (Biuret)
• Body Fluid Glucose - Enzymatic Colorimetric(Hexokinase)

• Cell Count/Differential Count: Hematology
• Body Fluid Protein and Glucose: Chemistry

• Cell Count/Diff Count: No patient preparation necessary
• Protein and Glucose: Preferably 8 hours fasting
• Send to Laboratory within 24 hours of collection.

Glucose and Protein:
• Bottle #1 placed on a plain tube (Red Top with no additive)

Cell Count/Diff Count:
• Bottle #2 placed on an EDTA Tube

• Cell Count/Diff Count: 3-5 mL
• Glucose and Protein: 3-5 mL

Not applicable

Glucose and Protein: 1 Day

Cell Count/Diff Count: 1 Day

Glucose and Protein: 6 Days

Cell Count/Diff Count: Not specified

Unacceptable

Transport specimen at 15–25 °C (room temperature)

• Quantity not sufficient
• Clotted sample (for Cell Count and Diff Count)
• Incorrect storage temperature of specimen
• Incorrect collection tube used
• Specimen stored exceeded required sample stability
• Highly viscous specimen
• Hemolyzed samples

Daily

Monday to Saturday: 10:00 PM

Sunday: 6:00PM

RUNNING TIME: 6:00 AM onwards

RELEASING TIME: ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
RELEASING TIME: STAT
• After 2½ hours from extraction/messenger arrival

Glucose:
Transudate: Approximates whole blood levels
Exudate: Lower than whole blood levels

Total Protein:
Transudate: <25.00 g/L
Exudate: >30.00 g/L

Specific Gravity:
Transudate: <1.016
Exudate: >/=1.016

White Blood Cells:
Transudate: <100.00 x 10^3/uL
Exudate: >1000.00 x 10^3/uL

None specified

Not applicable

Pericardial Fluid Analysis, Peritoneal Fluid Analysis, Gram Stain, Susceptibility Testing, Total Protein, Albumin, Glucose Tests, LD, CEA, Fungal Tests, AFB Testing, Adenosine Deaminase

Placental Growth Factor

Not applicable

• Mainly expressed in placental trophoblasts, PLGF has a major role during pregnancy and pathological conditions including ischemia, wound healing and tumor progression.
• Used as an aid in screening & monitoring of pregnant women for pre-eclampsia in all trimesters of pregnancy
• Used as an aid in calculating for risk of Down’s Syndrome in the first trimester of pregnancy

Time-resolved Fluoroimmunoassay

Immunology

• No patient preparation required.

For PlGF monitoring patients, draw blood during:

• 2^ndTrimester: 20^thto  27^thgestation weeks
• 3^rdTrimester: 28^thto 40^thgestation weeks

Red or Gold tube

1-3 mL Serum

Not applicable

2 days

*Must be separated from red cells or serum separature tube gel plugs

30 days

*Must be separated from red cells or serum separature tube gel plugs

Not specified (no more than 6 freeze-thaw cycles)

*Must be separated from red cells or serum separature tube gel plugs.

• Separate the serum from clot or gel separator ASAP after centrifugation.
• Transported specimen at 2⁰C to 8⁰C (with cold packs)

• Improperly labeled specimens
• Hemolyzed specimens
• Lipemic specimens
• Improper collection tube used
• Specimen transported outside the required temperature.
• Quantity not sufficient

1st And 3rd Monday Of The Month

Friday, 6:00PM

Releasing of Results:

Blood markers (PlGF and PAPP-A): 3 Days After Running Day

Risk Assessment of Pre-Eclampsia Result: 3 Days After Running Day

• Result not available online
• Patient will be the one to pick up result.
• Soft copy will be saved in HPD Branch Special Test result shared folder.

• No Reference Range established for screening test. Must be used in conjunction with other tests and information to calculate/assess risk for pre-eclampsia.

• Samples containing heterophilic antibodies give falsely elevated results
• Complement activation may in some rare cases give falsely low results

Q: Who should be screened for pre-eclampsia?

A: All pregnant women should be assessed early on in their pregnancy to prevent the development of pre-eclampsia. They should also have access to screening even if there are no maternal risk factors or history of pre-eclampsia.

Q: Why does all pregnant women need to be assessed for pre-eclampsia?

A: The benefit of detecting and treating pre-eclampsia early in the pregnancy always outweighs the conventional wait-and-see approach to pre-eclampsia management.

Q: What should women know?

A: While pre-eclampsia screening is critical to protecting the health of mother and child, many women are unaware of pre-eclampsia or combined pre-eclampsia screening with the PlGF 1-2-3 assay. They need to know that pre-eclampsia can affect any pregnancy. They should also be informed that some pregnancies are more at risk of developing pre-eclampsia than others. Combined pre-eclampsia screening with the PlGF 1-2-3 assay is an effective way to assess this risk. In fact, women with a history of pre-eclampsia have a three to four times greater risk of developing chronic hypertension than mothers with no history of pre-eclampsia and double the risk of ischemic heart disease, venous thromboembolism and stroke.

Q: What do the results mean?

A:Low risk- Low risk means that there is minimal risk of developing pre-eclampsia later in pregnancy. While it is possible to develop pre-eclampsia regardless of low risk status, the pregnancy can continue as normal and the mother can rest assured that there is little or no reason for concern.

High risk– If the risk of developing pre-eclampsia later in pregnancy is high, the doctor can start treatment at the optimum time and monitor the pregnancy more closely. While not all women in the high-risk group develop pre-eclampsia, doctors can now offer the best possible care early in the pregnancy and significantly improve the outcome for mother and child:

• Trimester 1 – Start preventive actions
• Trimester 2 –Close monitoring
• Trimester 3 – Prepare for early delivery and needed actions.

Not Applicable

Monohydroxybenzene

Not applicable

Pneumocystis carinii, now considered a fungus, is an opportunistic infection seen especially in patients infected with HIV and on immunosuppressive therapy, e.g. post-transplantation. Pneumocystis carinii causes pneumonia.

Immunoflourescent

Special Test

No patient preparation necessary.

Plastic leak proof clean container

2 mL induced sputum

2 mL bronchial alveolar lavage or bronchial washing

7 Days

7 Days

unacceptable

Transport specimen at 2 – 8 °C (with cold packs)

•Quantity not sufficient
• Received room temperature
•Improperly labeled specimen
•Improperly collection container used

Batch Running

Friday 4:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Acute lymphocytic leukemia, Pneumocystis jiroveci pneumonia (PJP)

Not applicable

Not applicable

Poliovirus causes acute anterior poliomyelitis when it infects the central nervous system, usually the spinal cord but in some cases it reaches the medulla oblongata and causes irreversible paralysis. Poliomyelitis has almost been completely eradicated in the industrialized world. Serological analysis also gives a measure of the efficacy of immunization.

Neutralisation Test

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Friday, 4:00 PM

1 month after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Not applicable

Not applicable

Not applicable

Colorimetric

Special Test

Collection Procedures :
1. Instruct the patient to void at the beginning of collection period and discard the specimen.
2. Collect all urine including the final specimen voided at the end of collection period.
3. Mix 24 hour urine collected.
4. Label the bottle with patient name, date & time collection started, date & time collection ended and total volume measured.
5. Note total volume.
6. Submit the specimen to HPD

Plastic leak proof clean container without preservative

100 mL of 24 hour Urine

Not Applicable

Unacceptable

7 Days (ph 6-7)

30 Days (ph 6-7)

Transport specimen at 2 – 8 °C (with cold packs)

•Quantity not sufficient
• Received room temperature
•Improperly labeled specimen
• Improper urine collection

Batch Running

Monday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

•K

Not applicable

• Used for evaluation of electrolyte imbalance, cardiac arrhythmias, muscular weakness, hepatic encephalopathy, and renal failure
• Used for monitoring of ketoacidosis in diabetes mellitus and intravenous fluid replacement therapy.

Direct ISE

Chemistry

• Patient should not clench fist or exercise the arm prior to or during venipuncture.

Instruction to Phlebotomists/Processors
• Application of torniquet should not exceed 15 seconds as it may increase Potassium level
• Separate serum from red cells within 2 hours from collection
• Do not refrigerate samples prior to centrifugation.

Red or Gold tube

1-3 mL Serum

Not applicable

14 Days (Serum must be separated from Gel separator)

14 Days (Serum must be separated from Gel separator)

Not specified

• Uncentrifuged sample: Room temperature (15-25°C)

NOTE: Sample must be separated from serum within 2 hrs of collection

• Centrifuged sample:  Refrigerated Temperature (2 – 8 °C) (with cold packs)

• Improper collection tube used
• Specimen stored/transported outside the temperature range
• Quantity not sufficient
• Specimen with any sign of hemolysis
• Lipemic specimen
• Improperly labeled specimen
• EDTA plasma

Daily

Monday to Saturday: 6:00 PM

Sunday: 4:00PM

ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
STAT
• After 2½ HOURS from extraction/messenger arrival

0-17Y: 3.70-5.00 mmol/L (3.70-5.00 meq/L)
17Y & 1 Day - 999Y: 3.50-5.30 mmol/L (3.50-5.30 meq/L)

None identified.

Not applicable

Chloride, Sodium, Bicarbonate, Electrolytes, Basic Metabolic Panel, Comprehensive Metabolic Panel, Aldosterone and Renin

Panel Reactive Antibody

Not applicable

• Panel Reactive Antibody (PRA) elevation is a measure of allosensitization, and it has been shown to negatively impact post-heart transplant (HTx) survival. Ventricular assist device (VAD) implantation is associated with elevated PRA. Whether VAD-related PRA elevations predict post-HTx survival remains controversial.

Luminometry

Special Test

• No patient preparation necessary.
• Pease get form to Special Test Section
• Fill up the DONOR and RECIPIENT FORM 
• Call Special Test Section (By Appointment/Schedule).

NOTE: Do not collect specimen without approval of Special Test Section

Red tube Only

2 mL Serum

Not Applicable

Not applicable

24 Hours

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Tuesday 7:00 AM

Monday 7:00 AM

Friday 5:00 PM

Available upon request

None specified.

Not applicable

for post-transplant monitoring and consists of HLA Class I & II Panel Reactive Antibody (PRA), the presence/absence of DSA(s), and the strength/trend of the DSA(s).

• Panel Reactive Antibody Class 1

Not Applicable

Luminometry

Special Test

• No patient preparation necessary.
• Pease get form to Special Test Section
• Fill up the DONOR and RECIPIENT FORM 
• Call Special Test Section (By Appointment/Schedule).

NOTE: Do not collect specimen without approval of Special Test Section

Red tube only

2 mL Serum

Not Applicable

Not applicable

Not applicable

5 Days

Transport specimen with dry ice

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Tuesday 7:00 AM

Monday 7AM

Friday 5:00 PM

Available upon request

None specified.

Not applicable

for post-transplant monitoring and consists of HLA Class I & II Panel Reactive Antibody (PRA), the presence/absence of DSA(s), and the strength/trend of the DSA(s).

• Panel Reactive Antibody Class 1 and 2

Not applicable

Luminometry

Special Test

Not applicable

• Fill up the DONOR and RECIPIENT FORM 

( Pease get form to Special Test Section)

• No patient preparation necessary.
• Call Special Test Section (By Appointment/Schedule).

NOTE: Do not collect specimen without approval of Special Test Section

Red tube only

2 mL Serum

Not Applicable

Not applicable

Not applicable

5 days

Transport specimen with dry ice

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Tuesday 7:00 AM

Monday 7AM

Friday 5:00 PM

Available upon request

None specified.

Not applicable

for post-transplant monitoring and consists of HLA Class I & II Panel Reactive Antibody (PRA), the presence/absence of DSA(s), and the strength/trend of the DSA(s).