BLOOD TESTS FOR NETs
Bloodwork should be fasting for 12 hours for the following tests:
Chromogranin-A
Insulin
Proinsulin
C-peptide (14 hours)
Gastrin
Histamine
Glucagon
Pancreatic polypeptides
| BLOOD TEST | DESCRIPTION |
|---|---|
| ACTH | Helps determine the cause of high and low cortisol levels |
| Alpha subunit pituitary marker | Helps identify pituitary and non-pituitary tumours |
| B12 | Helps identify certain types of anemia |
| C-peptide (serum) | Part of a diagnostic evaluation of blood glucose and insulin |
| Calcitonin | Diagnosis and follow-up of medullary thyroid carcinoma |
| Chromogranin A | Because of its wide distribution in neuroendocrine tissues, this test can be a useful diagnostic marker for NETs. Note that chromogranin A levels may be falsely elevated PPI medications are being used. |
| Complete blood count | A basic screening tool for many blood disorders |
| Cortisol | Evaluates adrenal insufficiency, particularly the diagnosis of Cushing syndrome |
| Electrolytes (serum) | Tests levels of sodium, potassium, chloride, bicarbonate (and other substances) to identify a range of clinical disorders |
| Follicle Stimulating Hormone | Useful for diagnosing pituitary disorders and evaluating levels of sex hormones |
| Gastrin | Used to investigate levels of stomach acid (gastrin), including suspected cases of Zollinger-Ellison syndrome/gastrinoma. Note that gastrin levels may be falsely elevated if PPI medications are being used. |
| GH-RH (Growth hormone releasing hormone) | Used to evaluate the ability of the pituitary gland to release growth hormone |
| Glucagon | Evaluates levels of glucagon, produced by pancreatic cells, which help to maintain blood glucose levels |
| Gn-RH (gonadotrophin releasing hormone) | Used to tell the difference between primary and secondary hypogonadism, a condition in which the sex glands produce few, if any, hormones |
| Insulin-like Growth Factor (IGF-1) | Increased levels of IGF-1 are frequently associated with pituitary tumours |
| Insulin | Used to help diagnose insulinoma when used in conjunction with proinsulin and C-peptide measurements |
| Insulin/glucose ratio | Used as a screening test for insulin resistance (how well the pancreatic cells respond to insulin) |
| Luteinizing Hormone (LH) | Used to help diagnose pituitary disorders |
| Neurokinin A (substance K) | A test that evaluates circulating levels of neurokinin A, high levels of which may indicate a poor prognosis in certain types of NETs Not yet available in Canada. Available in the U.S.† |
| Pancreastatin | A new test that uses measurements of pancreastatin to potentially identify NETs at an earlier stage with greater clarity Not yet available in Canada. Available in the U.S.† |
| Pancreatic polypeptide | Used for detection of pancreatic NETs |
| Plasma catecholamine | Used to help diagnose pheochromocytoma and paraganglioma. Also used for the diagnosis and follow-up of neuroblastoma and related tumours. |
| Plasma fractionated metanephrines | The gold standard test used in the diagnosis of pheochromocytoma |
| Proinsulin | Used as part of the diagnostic work-up of suspected insulinoma |
| Prolactin | Used in the evaluation of pituitary tumours, menstrual disorders, abnormal milk production, infertility and low sex hormones |
| PTH-related peptide | Used as part of a diagnostic work-up in patients who may have high calcium levels resulting from cancer |
| Somatostatin | Used to evaluate the amount of somatostatin in the blood in suspected pancreatic NETs |
| Thyroid Stimulating Hormone (TSH) | Used to evaluate thyroid function and/or symptoms of hyperthyroidism or hypothyroidism, or to evaluate the function of the pituitary gland |
| Vasoactive Intestinal Polypeptide (VIP) | Used to evaluate vasoactive intestinal polypeptide producing tumours in patients who are experiencing chronic diarrhea |