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Test Code VEGF Vascular Endothelial Growth Factor (VEGF), Plasma


Specimen Required


Collection Container/Tube: Lavender-top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Immediately after drawing the specimen, place the tube on wet ice.

2. Spin down and separate plasma from cells; 1,500 x g for 10 minutes at 4° C.

3. Freeze specimen within 30 minutes


Useful For

Evaluation of patients with suspected POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, particularly in differentiating from other forms of polyneuropathy and monoclonal plasma cell disorders

  Monitoring response to treatment in patients with a known diagnosis of POEMS syndrome

Method Name

Electrochemiluminescence

Reporting Name

Vascular Endothelial Growth Fctr, P

Specimen Type

Plasma EDTA

Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma EDTA Frozen (preferred) 21 days
  Refrigerated  24 hours

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; gross reject

Icterus

Mild OK; gross reject

Other

Specimens other than EDTA plasma

 

Clinical Information

Vascular endothelial growth factor (VEGF) is a critical modulator of angiogenesis (the growth of new blood vessels).(1) In mammals, there are 5 members of the VEGF family, with VEGF-A being the most well-studied. VEGF-A promotes angiogenesis by inducing migration of endothelial cells, promoting mitosis of endothelial cells, and upregulating matrix metalloproteinase activity.(2) VEGF-A is regulated by hypoxia, with increased expression when cells detect an environment low in oxygen. Physiologically, VEGF induces new blood vessel formation during embryonic development, after tissue injury, and in response to blocked vessels.

  VEGF also regulates pathological vessel formation, such as in tumor growth and metastases. Angiogenesis during tumor development is complex, although it is clear that VEGF plays a key role. VEGF also regulates angiogenesis in other disease states including rheumatoid arthritis (RA), osteoarthritis, diabetes, and age-related macular degeneration.(3) In addition, circulating concentrations of VEGF are elevated in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome, a monoclonal plasma cell disorder.(4) Although the pathologic role of VEGF in POEMS is unclear, it is a useful diagnostic marker for assessing response to therapy.

Reference Values

≤96.2 pg/mL

Interpretation

Elevated concentration of vascular endothelial growth factor (VEGF) may be consistent with a diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome.   Decreasing concentrations of VEGF over time in a patient with POEMS syndrome may be consistent with a therapeutic response.

Cautions

Elevated circulating concentrations of vascular endothelial growth factor (VEGF) may be observed in a variety of disease states, especially those associated with angiogenesis. Elevated concentrations of VEGF must be interpreted within the clinical context of the patient.

 

Normal concentrations of VEGF do not exclude the diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome.

 

VEGF has limited stability. Following centrifugation, plasma must be either immediately frozen or refrigerated. Samples can only be stored at refrigerated temperatures for 24 hours, after which time samples must be frozen. Storage of plasma for any length of time at room temperature is not acceptable.

Method Description

The vascular endothelial growth factor (VEGF) cytokine assay measures human cytokines in a 96-well spotted plate. The assay employs a sandwich immunoassay format where capture antibodies are coated on a single spot on the bottom of each well. Diluted samples, calibrators, and controls are added and to the plate. If present, VEGF will bind to the capture antibodies. After incubation, a solution containing detection antibodies conjugated with electrochemiluminescent labels is added. After a final incubation, a buffer is added that creates the appropriate chemical environment for electrochemiluminescence. The plate is then read on the Sector Imager 2400. The machine applies a voltage that causes bound labels to emit measurable light. The Sector Imager 2400 measures the intensity of emitted light and correlates it to a set of standards of known quantity via a 4-point logistics curve fitting method.(Package Insert: Human VEGF V-plex, Mesoscale Discovery, Rockville, MD 20850 USA 18095-v2-2014 Jan)

Day(s) and Time(s) Performed

Thursday, 3 p.m.

Analytic Time

1 day

Specimen Retention Time

14 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

83520

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VEGF Vascular Endothelial Growth Fctr, P 34694-0

 

Result ID Test Result Name Result LOINC Value
63019 VEGF, P In Process