To help diagnose and monitor carcinoid tumours and other neuroendocrine tumours
Chromogranin A
When you have symptoms suggestive of a carcinoid tumour such as flushing, diarrhoea, and/or wheezing. When your doctor thinks you may have a carcinoid or other neuroendocrine tumour
A blood sample taken from a vein in your arm
You may be required to fast overnight prior to the specimen being taken and to temporarily discontinue certain medication beforehand. Please check the local laboratory instructions with your doctor prior to blood being taken.
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How is it used?
The Chromogranin A test is used as a tumour marker. It may be requested in combination with or in place of 5-HIAA to help diagnose carcinoid tumours. It is also used to help monitor the effectiveness of treatment and detect recurrence of this tumour. Sometimes it may be requested with specific hormones, such as catecholamines, to help diagnose and monitor a phaeochromocytoma. It may also be used to detect the presence of other neuroendocrine tumours, even those that do not secrete hormones.
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When is it requested?
CgA is requested along with other tests when a doctor suspects that a patient has a carcinoid tumour, phaeochromocytoma, or other neuroendocrine tumour. It may be requested periodically to help evaluate treatment effectiveness and monitor for tumour recurrence.
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What does the test result mean?
Chromogranin A concentrations are normally low. Increased concentrations in a symptomatic patient may indicate the presence of a tumour but will not tell the doctor what type it is or where it is. The quantity of CgA is not associated with the severity of a patient’s symptoms but is associated with the tumour burden – the mass of the tumour.
If concentrations of CgA are elevated prior to treatment and then fall, then treatment is likely to have been effective. If following treatment of the tumour concentrations begin to rise again, then the patient may have a recurrence of the tumour.
When interpreting the result of chromogranin A blood test, caution is recommended, bearing in mind the multitude of factors that may lead to both false positive and negative results.
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Is there anything else I should know?
CgA concentrations may be elevated in other conditions, such as liver disease, inflammatory bowel disease, renal insufficiency, and with stress. These possible causes for elevated CgA concentrations should be considered when interpreting test results.
A variety of methods are available for measuring CgA. Those CgA tests that have been developed and validated by laboratories will all be slightly different and their results will not be interchangeable. For this reason, if a patient is having more than one CgA test performed (such as for monitoring) then his or her doctor will generally send each sample to the same laboratory. -
Should everyone have a Chromogranin A test?
No. This test is usually requested to help diagnose and monitor a carcinoid or other neuroendocrine tumour, both of which are uncommon. Most people will never need to have this test performed.
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How does a doctor locate the carcinoid or neuroendocrine tumour?
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How does the doctor tell whether a tumour is benign or cancerous?
They need to perform a biopsy or remove the tumour surgically and look at the tumour cells under the microscope.