Specimen Collection
Collection Handling:
Put URGENT sticker on the form
Collect on ice
Send sample immediately to the lab (within 15 minutes)
Specimen Requirement
Adult:
2 x 4ml plain (or SST) tubes (1 to LabPlus for Chromogranin A -1 to Canterbury Health labs for Gastrin)
2 x full 4ml EDTA (lavender) tubes (fill to the mark) for VIP, PP, Glucagon (to Canterbury Health labs)
Paediatrics:
2 x 1ml Paediatric micro-sample (or micro-SST) - fill to the mark to ensure adequate volume
3 x 2ml Paediatric micro-EDTA - fill to the mark to ensure adequate volume
Tests available in NZ laboratories - Refer to the specific section of the Test Guide via the links below for specimen handling and collection instructions for each particular assay as required.
LabPlus - Chromogranin A
Canterbury Health Labs - Vasoactive Intestinal Peptide (VIP), Pancreatic Polypeptide (PP), Gastrin & Glucagon
Referral from Te Toka Tumai Te Whatu Ora District - ask patient to go to LabPlus Outpatient Collection room at level 6, Building 1, Auckland City Hospital (next to the chapel) before 12 noon (as patients are fasted) on a working weekday.
Referral from other districts - please liaise with your local laboratory to ensure minimal delay between collection and centrifugation/separation/storage in the laboratory.
A. Gut Hormone Screen - requested as a panel; all 5 tests will be performed:
Patient Preparation before blood test
- Requires fasting overnight of at least 10 hours (predominantly for Gastrin, Glucagon and PP)
- Ideally avoid proton pump inhibitors for 2 weeks - at clinician's discretion
- Ideally avoid H2 blockers for at least 3 days (for gastrin) - at clinician's discretion
B. Individual test requests (see separate Test Guide entries for specific collection/transport requirements):
- Somatostatin or Chromogranin B - testing are very rarely required - they will ONLY be processed and sent to Gut Hormone Laboratory in Northwest London Laboratory in UK (previously described as Hammersmith Gut Hormone laboratory) after:
- prior approval by a gastroenterologist, endocrinologist, neuroendocrine surgeon or medical oncologist
AND
- the other gut hormone results have been considered
These requests will be vetted by the on-call Chemical Pathologist , name and job title of the approval specialist is required on the lab request form. For sample collection requirements, please click -Somatostatin entry below then click -UK Test Guide for Gut Hormone.
Investigation of chronic diarrhoea relating to hormone hypersecretion from some neuroendocrine tumours:
- 24-hour urine 5 HIAA (metastatic carcinoid tumour)
- Gastrin (Zollinger-Ellison syndrome)
- Calcitonin, CEA (medullary thyroid carcinoma)
- VIP (VIPoma- Verner-Morrison syndrome)
- Glucagon (Glucagonoma -Becker syndrome)
- Somatostatin (Somatostatinoma) - requires specialist approval as it is an expensive send away test ? see above
Laboratory Notes
- Centrifuge and separate within 1 hour of collection (VIP, Glucagon, Gastrin are least stable).
- Store the samples frozen at -20 o C.
- Transport to Canterbury Health laboratories frozen. Ensure samples do not thaw.