Estrogens, Fractionated, LC/MS

Test Code

36742

CPT Codes
82671

Includes

Estrone
Estradiol, Ultrasensitive, LC/MS
Estriol, Serum

Preferred Specimen

2.5 mL serum collected in a red-top tube (no gel)

Minimum Volume

1.5 mL

Instructions

Specify age and sex on test request form

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 24 hours
Refrigerated: 7 days
Frozen: 28 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Serum separator tube (SST) • Gross hemolysis • Grossly icteric • Lipemia

Methodology
Chromatography/Mass Spectrometry

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Daily; Report available: 2-5 days

Reference Range

See individual tests

Clinical Significance

This panel measures the concentrations of estrone, estradiol, and estriol, the 3 main types of estrogens in serum. This panel may be useful in assessing estrogen status.

Estrogens are endogenous steroids that regulate growth and maintenance of sex organs and secondary sex characteristics in women. Estrogens also have effects on many other organ systems such as maintenance of bone density, production of liver proteins, arterial vasodilation, reduction of intraocular pressure, and influence on mood [1]. Measurements of estrogens may help evaluating sexual maturity, menstrual abnormalities, fertility abnormalities, fetal-placental health in pregnancy, tumors that excrete estrogens, and feminization syndromes in men [2].

Increased levels of estrogens may be observed in normal pregnancy, precocious puberty, hyperthyroidism, liver cirrhosis, and ovarian, testicular, and adrenal tumors. Decreased levels of estrogens may be observed in failing pregnancy, Turner syndrome, hypopituitarism, primary and secondary hypogonadism, menopause, Stein-Leventhal syndrome, and anorexia nervosa [3].

Estriol becomes the predominant estrogen only in late pregnancy. Measurements of estriol are commonly used to help screen for certain fetal abnormalities such as Down syndrome. In non-pregnant women and men, measurements of estriol have limited clinical use [2].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Gruber CJ, et al. N Engl J Med. 2002;346(5):340-352.
2. Haymond S, et al. Reproductive related disorders. In: Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Inc; 2006:2097-2152.
3. Pagana K, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed. Elsevier Inc; 2020:346-400.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.