Test in Focus

In this episode of “A Test in Focus,” Sanjeev Sethi, M.D., Ph.D., explains Mayo Clinic Laboratories’ new immunohistochemistry assay for the detection of NELL-1 antigen, a biomarker for membranous nephropathy (MN). Identified by Dr. Sethi in 2019, NELL-1 antigen triggers the production of NELL-1 antibodies, which are present in approximately 10% to 15% of MN patients and may be associated with an underlying cancer.

“While many cases of NELL-1 are primary and there’s no disease association, there are multiple studies now that show a subset of NELL-1 positive patients have an underlying malignancy,” Dr. Sethi says. “So if a physician gets a diagnosis of NELL-1 membranous nephropathy, they need to be extra vigilant in screening for hidden malignancies, because it is possible that you treat the malignancy and then the membranous goes away as well.”

Dr. Sethi notes that establishing disease etiology through NELL-1 antigen detection not only enables accurate diagnosis, but elevates treatment outcomes by providing a disease expression on which to base follow-up care.

Listen to learn more about how NELL-1 antigen testing enhances MN diagnosis by equipping providers with specific information on disease manifestation.

Note: Podcasts will not playback on Internet Explorer. Please use an alternative web browser, or listen from your mobile device on a preferred listening app.


Useful for:

Identification of neural epidermal growth factor-like 1 protein (NELL1) primary membranous nephropathy

Specimen requirements

  • Supplies: Immunostain Technical Only Envelope (T693)
  • Specimen Type: Tissue
  • Container/Tube: Immunostain Technical Only Envelope
  • Preferred: 2 unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections 4-microns thick.
  • Acceptable: Formalin-fixed, paraffin-embedded (FFPE) tissue block

Performance information

  • Day(s) and time(s) test performed: Monday through Friday
  • Analytic time: 1 to 3 days

Related testing

The latest from Test in Focus

Samantha Rossi

Samantha Rossi is a Digital Marketing Manager at Mayo Clinic Laboratories. She supports marketing strategies for product management and specialty testing. Samantha has worked at Mayo Clinic since 2019.