IHC Marker-SALL4 Test: Booking, Price, and Results
About IHC Marker-SALL4 Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | SALL4 Immunostain, SALL4 IHC, Sal-like Protein 4 IHC, SALL4 by Immunohistochemistry |
| Sample Type | Formalin-fixed paraffin-embedded (FFPE) tissue block |
| Fasting Required | No—this test is performed on tissue samples, not blood |
| Report Time | 3 Days |
| Recommended For | Individuals of all ages; commonly ordered when a germ cell tumour is suspected |
| Price | Starting at ₹1,920 |
What Is an IHC Marker-SALL4 Test?
The IHC marker-SALL4 test is a specialised pathology test that detects a protein called SALL4 (sal-like protein 4) in tumour tissue. It is performed using a technique called immunohistochemistry (IHC), which uses antibodies to stain tissue samples so a pathologist can examine them under a microscope. Doctors order this test to help determine the origin and classification of a tumour, particularly when a germ cell tumour is suspected. Also known as the SALL4 IHC (Sal-like Protein 4 Immunohistochemistry) test, it is performed on a preserved tissue block obtained through a biopsy.
What Does an IHC Marker-SALL4 Test Measure?
The SALL4 test analyses tissue for two key things.
| What Is Measured | Why It Matters |
|---|---|
| SALL4 protein expression | Identifies whether tumour cells carry this stem cell protein, which is closely linked to germ cell tumour origin |
| Tumour cell staining pattern | Only nuclear staining (staining within the cell nucleus) counts as positive; staining intensity and the percentage of cells stained are both graded |
Why Is an IHC Marker-SALL4 Test Done?
Doctors order the SALL4 IHC test when they need to determine the nature of a tumour, particularly in cases where standard tests have not provided a clear diagnosis.
Common Symptoms That May Require This Test
A doctor may recommend a biopsy and subsequent SALL4 IHC testing if a patient presents with any of the following symptoms:
- A painless lump in the scrotum
- A painless lump in the neck, abdomen, or lower back
- Persistent sharp or unexplained pain in the abdomen or pelvis
- Abdominal pain and constipation, which may suggest an ovarian tumour
- Shortness of breath, which may point to a tumour in the chest cavity
- Headaches or changes in vision, which may indicate a tumour in the brain
Conditions This Test Can Help Detect
The SALL4 immunostain helps pathologists identify and classify certain tumours, particularly those of germ cell origin. It is interpreted alongside tumour morphology and other immunohistochemical markers.
- Seminomas (a type of testicular cancer) and dysgerminomas (ovarian germ cell tumours)
- Embryonal carcinomas and yolk sac tumours, including those that have spread to other parts of the body
- Germ cell tumours arising outside the reproductive organs, such as in the mediastinum, retroperitoneum, or brain — particularly in patients under 40
- Distinguishes ovarian yolk sac tumour from clear cell carcinoma of the ovary, a distinction that is difficult to make with other markers
- Helps differentiate germ cell tumours from many lymphomas, melanomas, and carcinomas when used as part of a broader diagnostic panel
How to Prepare and What to Expect
Because this test is performed on tissue already collected via biopsy, the preparation relates to the biopsy procedure itself rather than a routine blood draw.
Do You Need to Fast?
No fasting is required for SALL4 test procedure. This test is carried out on tissue that has already been collected during a biopsy procedure. Your doctor will give you separate instructions if fasting is needed for any other procedure done at the same time.
Practical Tips Before Your Test
Here are a few things to keep in mind ahead of your appointment.
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test.
- Inform your doctor about all medications you are currently taking, including blood thinners, as these may affect biopsy scheduling.
- Ask your treating doctor to explain the biopsy procedure and any specific preparations needed beforehand.
Step-by-Step Procedure
- A doctor collects a tissue sample via biopsy. The method may range from a needle biopsy (inserting a fine needle into the tumour) to an excisional biopsy (surgical removal of part or all of the tumour).
- The collected tissue is fixed in formalin to preserve its structure and then embedded in paraffin wax in the pathology laboratory.
- The paraffin block is sliced into very thin sections (approximately 4 to 5 microns thick) and placed on glass slides.
- Specially designed antibodies are applied to the slides. These antibodies bind to the SALL4 protein if it is present, producing a visible stain.
- A qualified pathologist examines the stained slides under a microscope and assesses the location, intensity, and extent of staining.
- A written report is prepared and delivered to your doctor, typically within 3 days.
Factors That Can Affect Accuracy
Several factors can influence the reliability of your SALL4 test result:
- Incomplete or missing clinical history submitted alongside the sample
- Use of a fixative other than 10% formalin during tissue preparation
- Age of the paraffin section (sections older than six weeks may give less reliable results)
- Poor glass slide quality or incorrect storage conditions
- Environmental factors affecting the charge on tissue slides
Understanding Your IHC Marker-SALL4 Test Results
Results from the SALL4 IHC test are reported as positive or negative, with additional detail on staining intensity and distribution. These findings are interpreted by a pathologist alongside imaging results, other IHC markers, and your full clinical history.
| Result | General Interpretation |
|---|---|
| Positive (nuclear staining present) | SALL4 protein is detected; suggests a germ cell tumour origin. Further investigation may be needed. |
| Negative (no nuclear staining) | SALL4 protein is not detected; the findings do not support a germ cell tumour origin |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain situations can make SALL4 results more difficult to interpret:
- In normal adult testicular tissue, SALL4 is naturally expressed in spermatogonia (the cells that produce sperm). A pathologist will differentiate this normal positivity from tumour-related positivity when reading results.
- Some non-germ cell tumours, such as serous carcinoma of the ovary, urothelial carcinoma, and gastric adenocarcinoma, may show SALL4 positivity in a proportion of cases. In these situations, testing for other stem cell markers such as OCT4 and NANOG alongside SALL4 can help clarify the diagnosis.
How to Maintain Healthy Levels
SALL4 is a diagnostic marker and its expression cannot be altered through lifestyle changes. General awareness, however, plays a role in early detection.
- Attend regular health check-ups and report any new or unexplained lumps, persistent pain, or unusual symptoms to your doctor promptly.
- Stay informed about your family history of cancer and share this with your healthcare team.
- Follow your doctor's guidance on any follow-up tests or imaging recommended alongside this marker.
Lupin Diagnostics IHC Marker-SALL4 Test Price
The SALL4 test cost at Lupin Diagnostics starts at ₹1,920. This test requires a visit to a Lupin Diagnostics centre, as home collection is not available for tissue-based tests.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 1920 |
| CHENNAI | 1920 |
| HYDERABAD | 1920 |
| KOLKATA | 1920 |
| NAVI MUMBAI | 1920 |
| PUNE | 1920 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection or submission of your FFPE tissue block.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The IHC marker-SALL4 test helps pathologists determine whether a tumour has originated from germ cells (the cells that give rise to eggs and sperm). It distinguishes germ cell tumours from other cancers such as carcinomas, lymphomas, and melanomas. It is particularly useful when a tumour's origin is unclear from standard investigations.
The test requires a formalin-fixed paraffin-embedded (FFPE) tissue block, which is a preserved tissue sample obtained through a biopsy. The biopsy is performed by your treating doctor at a hospital or surgical centre before the block is submitted to the laboratory.
No fasting is required. The SALL4 IHC test is carried out on preserved tissue, not on blood or urine, so there are no dietary restrictions before sample submission.
A positive result supports the diagnosis of a germ cell tumour such as seminoma, embryonal carcinoma, or yolk sac tumour. The result should always be interpreted together with microscopic findings, other IHC markers, imaging studies, and clinical information.
No. While the SALL4 test is commonly used in the evaluation of testicular germ cell tumours, it is also useful for ovarian germ cell tumours and germ cell tumours that arise outside the reproductive organs, such as those in the chest (mediastinum), abdomen (retroperitoneum), or brain. It may be used in individuals of any age or sex when a germ cell tumour is suspected.
Yes. A detailed clinical history is required for this test. Bring documentation of your symptoms, any previous test results (such as imaging reports and blood tumour markers), and your family history of cancer. This information helps the pathologist interpret the staining results accurately.
IHC Marker-SALL4 Test: Booking, Price, and Results
