What Does My Lab Test Report Indicate?

Posted on Fri, 9 Jun 2017

Question: I am concerned about a test result my husband had. He was tested for chromogranin a for carcinoid to put my mind at ease. His results were 62 and the referenece range on the test was >93. So they were fine. However i looked up notmal chromogranin a levels and on carcinoid foundation it said 39 was normal. I wanted to make aure that this was jsut differenece in testing and not something that only carcinoid specialist would know. I am very concerned that his doctor may miss this. Is this incorrect information and is it based on the lab? It was a mayo clinic lab. I am eorried that this is only something a carcinoid specialist woukd know. Please help me.

Answered by Dr. Shehzad Topiwala (2 hours later)

Brief Answer:
Lab

Detailed Answer:
I understand your question and concern. As you have correctly surmised that each laboratory provides their own reference range for normal. So as you are saying that this particular report of Chromogranin A appears to be within normal limits with a Mayo Clinic range. However I will add that in general 24 hour urine testing for 5 HIAA ( Hydroxy Indole Acetic Acid) is a preferred way to screen for the possibility of Carcinoid syndrome. You may wish to discuss this with your endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 minute later)

Ok. Thank you. He had this done years ago and it was normal. Im sorry as i mist be frustrating. I just want to make sure there is no concern . So these are different with all labs? This isn't just something an endocrinologist would be aware of? So the site I read must have been referring to a specific assay? Should I not worry about the results? Like the Mayo Clinic had the wrong reference ranges? It is reliable correct?

Answered by Dr. Shehzad Topiwala (49 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Yes indeed each laboratory uses a specific method ('assay') for which the manufacturer of the testing kit provides normal reference ranges. It is a fairly complex issue because sometimes the assay is an unreliable one. You will have to show the report in-person to an endocrinologist who will also need to examine the patient

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shehzad Topiwala (7 hours later)

Mayo clinic is a reliable testing place correct? And if it is in their normal range than it mist be ok. I just want to make sure that his family doctor does not need to to know anything special as i just found this on google. But as i was asking it seems that different labs have different standards that they have develooed through testing. So this one is standardized for their lab as i read on their site. "Reference values were derived from 162 donors (68 [42%] male and 94 [58%] female), ages 21 to 79. There was no age (p>0.17) or gender (p>0.85) association at the 97.5th percentile, so the overall reference range of <93 ng/mL (97.5% CI: 86, 99) was calculated." My husband is not wirried and will not talk to his doctor about the reaukts as he feels this is a negative test result and that is enough for him. Can i reat assures that his chromogranin is normal?Ok I cannot talk to another endocrinologist. I just want to make sure that based on the range, the result I told you and the validating data I showed you from the lab that this is reliable. It is a homogenous time resolved immunoflourescence assay. Mayo Clinic labs. Should be good right and they all have their own reference ranges. I need to be able to accept the results. Please help.

Answered by Dr. Shehzad Topiwala (4 hours later)

Brief Answer:
Second follow up

Detailed Answer:
Yes Mayo clinic has a credible laboratory. But please note my other comment, as to how 24 hour urine 5HIAA is a better test to screen for the possibility of Carcinoid

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (12 minutes later)

So you would trust this as a doctor and his result is normal. I can rest easy? He had that years ago and it was negative. Thank you. I just want to make sure i can stop worrying .

Answered by Dr. Shehzad Topiwala (9 hours later)

Brief Answer:
Third follow up

Detailed Answer:
Although this result is normal, I will emphasize yet again that this is not the best test for diagnosing carcinoid

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar