The Chromogranin A [CgA] blood test is ordered when there is a suspicion of a carcinoid syndrome present within a patient. It may also be routinely ordered to monitor the treatment of such a syndrome. In its early stages, carcinoid syndrome can be very difficult to detect. Many of the signs and symptoms of it are similar to other health issues that people have. The CgA blood test will discover the markers in the blood that a carcinoid tumor leaves.

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What is Chromogranin A?

CgA is a protein that is secreted into the blood when a carcinoid tumor has developed. It can only be found in tumor cells. When a blood sample is taken, then the levels of this protein in the blood can be measured to determine if the presence of a tumor is likely or not.

Are high CgA levels 100% a carcinoid tumor?

Carcinoid syndrome is a likely outcome when results are abnormal on this blood test, but it isn’t the only health issue that can cause this protein to appear in the blood. Chronic gastritis, the use of proton-pump inhibitors on a long-term basis, and renal failure have all been known to cause results to be abnormally high.

Can I affect CgA levels?

Your Chromogranin A levels vary on a daily basis. What people choose to eat can dramatically impact the levels of this protein that are seen. Patients are required to fast before having a CgA test. Once the first one is ordered, a follow-up every 3-6 months is typically recommended until the health concerns fade.

What do I need to do before the blood test?

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There may not be any fasting or other test preparation needed for the CgA blood test. Your doctor or laboratory may have specific instructions for you to follow based on your unique medical history.

How sensitive is the CgA blood test?

Most patients who have advanced carcinoids or have tumors that are symptomatic will create an abnormal or positive blood test result. About 10% of people who have advanced or symptomatic tumors, however, will test in the normal range. Because of this, the Chromogranin A blood test is often orders with a urine test called the 5-HIAA because certain protein markers can be detected there as well.

What is the normal range for CgA in the blood?

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Every laboratory has a specific range that will be classified as normal for them. In general, however, the normal range for CgA is 1.9-15 ng/mL. Anything above this may be an indication of the presence of a tumor. The good news is that when there is a positive result, about 80% of the tumors that are found tend to be benign. Having high levels of Chromogranin A is also a rather rare condition.

Is there a possibility of a false positive result?

People who have an autoimmune disease may have a false positive CgA blood test result. People who work with animals on a regular basis and are exposed to heterophile antibodies will also potentially have a false positive. When there are extremely high levels of Chromogranin A, then a false low can actually be achieved because of what is known as the hook effect. It means that there is so much CgA present that the test cannot measure all of it.

Are there other tumors that can be detected as well?

If false positive results have been ruled out, then there are a wide variety of endocrine tumors that can also be detected by the Chromogranin A blood test. This is because each type of tumor releases proteins and specific hormones that indicate what type of tumor it happens to be. Both malignant and benign tumors can be detected in this way.

How many tumors are located through CgA blood tests?

In the US, about 10,000 tumors or cancers, such as small cell lung cancer, are detected through the Chromogranin A blood test every year. It is believed that there are many more people who have these tumors, but they are small enough that they do not cause any symptoms.

What treatment options are there?

Treatment depends on the size of the tumor and whether it is malignant or not. A biopsy will often be performed as soon as the tumor is located to determine what it is. Medications and other treatment options are also available. Some doctors may recommend a “wait and see” approach. As with any important medical diagnosis, it is important to make sure a second opinion is obtained.

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Chromogranin A blood test results will typically be normal or high. Low results may be an indication of a laboratory error. Speak with your medical provider about your results to determine what they mean for you and what treatment options are available.

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Chroma was originally launched in 2018, via a very successful Kickstarter campaign, following 2 years of design and development by me, Steve Lloyd. I spent a lot of time, and learned a lot about the requirements of large format photographers, before I came up with the initial design for the first “Advanced45” camera system. Since then, I’ve launched a further three new cameras, along with a wide range of accessories.

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