Days Set Up
Analytic Time

5-12 days

MiChart Code
NRAS Mutation Detection in Malignancy
Soft Order Code

Test Updated:


N-RAS Mutation Detection

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All specimens should be accompanied by a requisition.

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Test Overview

Test Methodology

Next-Generation Sequencing

Test Usage

Activating mutations in the NRAS gene occur in approximately 2-3% of colorectal carcinomas, 20% of melanomas, and a variety of other human cancers. NRAS mutations are predominantly single nucleotide substitutions, occurring most frequently within exons 2 and 3 at codons 12, 13, and 61. These NRAS mutations are associated with poor clinical response to epidermal growth factor receptor (EGFR) targeted therapies in patients with colorectal cancer. This DNA test is performed by targeted next-generation sequencing to detect mutations within sequenced regions of NRAS exons 2, 3, and 4 (NM_002524.4; Hg19 chr1:115285690-115258774, chr1:115256505-115256584, chr1:115252191-115252305) including codons 12, 13, and 61. Specimens should contain an adequate proportion of neoplastic cells (>20%) in the area to be extracted to ensure mutation detection.

Reference Range

Interpretive report provided.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Specimen Requirements

Collection Instructions

For formalin-fixed, paraffin-embedded tissue, a block containing an area with a high percentage of neoplastic cells (for micro-/macro-dissection) is preferred. Unstained, UNBAKED slides (5-8, 10-micron slides; 10-15 if few neoplastic cells are present) with associated H&E stained slide are also acceptable. Decalcified tissue or other fixatives will be accepted and the assay attempted, however these may result in failed testing due to degraded nucleic acid. Both blocks and slides should be stored at room temperature. A Diff-Quik or Papanicolaou stained aspirate smear (preferable containing a high percentage and overall amount of neoplastic cells) is also acceptable. Store at room temperature..

Normal Volume
Formalin-fixed, paraffin-embedded tissue; Diff-Quik stained aspirate smear, Papanicolaou stained aspirate smear.Extracted DNA is also acceptable if extracted in a CLIA certified laboratory.
Minimum Volume

Billing Information

CPT Code
81311, 88381-TC (if applicable)
Pro Fee Code
Insurance Auth Info

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Our High Standard

Quality that sets us apart

As the reference laboratory division of Michigan Medicine's Department of Pathology, MLabs shares the institution's commitment to applying established quality principles to clinical laboratory testing. Like other large organizations in complex, consequential fields, we rely on an established approach to monitor quality throughout the testing process.