Hormone assays and tumour markers

Hormones and markers in Tunis, Tunisia · Centre Urbain Nord

Hormone assays (thyroid, fertility, pregnancy, adrenal, pituitary) and tumour markers for the diagnosis and follow-up of endocrine diseases and cancers.

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What is it?

Hormone assays explore the function of the endocrine glands: thyroid (TSH, T4, T3), pituitary (prolactin, cortisol, growth hormone), ovaries and testes (FSH, LH, oestradiol, progesterone, testosterone, AMH), adrenal glands, pregnancy (beta-HCG), diabetes (insulin, C-peptide), vitamin D and bone metabolism. They are used to diagnose a hormonal imbalance, investigate infertility, monitor a pregnancy or adjust a treatment. Tumour markers (PSA, CA 15-3, CA 125, CA 19-9, CEA, AFP, thyroglobulin, calcitonin…) are substances whose level can rise in the presence of certain cancers. They are mainly useful to follow the course of a known cancer and the effectiveness of treatment, alongside imaging and clinical examination. The partner laboratory of the Centre Médical Pasteur performs these assays on latest-generation analysers and takes part in external quality assessment programmes. As some hormones must be sampled at a precise time of day or of the cycle, the team advises the patient on the timing of the sample.

When is it indicated?

Fatigue, weight gain or loss, palpitations: thyroid tests

TSH, completed by free T4, is the first test to detect hypothyroidism or hyperthyroidism.

Fertility work-up for the couple

FSH, LH, oestradiol and AMH in women, testosterone in men, guide the management of infertility, together with the gynaecology department.

Pregnancy: beta-HCG and hormonal follow-up

The blood HCG assay confirms and dates an early pregnancy and allows its progress to be monitored.

Suspected adrenal or pituitary disease

Cortisol, ACTH, prolactin or growth hormone are measured according to a precise protocol, at the recommended time.

Cancer follow-up: tumour markers

In a patient treated for prostate, breast, ovarian or digestive cancer, the trend of the marker helps the oncologist assess the response to treatment.

Prostate screening and follow-up: PSA

PSA, interpreted together with clinical examination and imaging, contributes to the screening and follow-up of prostate diseases.

Preparation

1Cortisol and ACTH: sample in the morning around 8 am, at rest

2Female hormone work-up: at the beginning of the cycle unless otherwise indicated, stating the date of the last period

3Prolactin: sample taken calmly after a few minutes of rest, away from exercise or stress

4PSA: away from a rectal examination, a urinary infection or cycling exertion

5Report hormonal treatments, the contraceptive pill and current supplements

Procedure

Check of the timing and sampling conditions

Venous blood sample

Assay on an immunoassay analyser

Validation by the biologist taking into account age, sex, cycle or pregnancy

Report with adapted reference values and a comment if necessary

Duration

A few minutes for sampling; results the same day or within a few days depending on the assays

Results

Results are interpreted according to the context: time of the cycle, age, pregnancy, treatments. For tumour markers, it is the trend over time, compared with previous assays, that matters most; the biologist comments on it in the report.

Risks and side effects

Small bruise at the puncture site

An assay performed at the wrong time of the cycle or day may be difficult to interpret and need to be repeated

These risks remain rare. Your physician will inform you in detail before the examination.

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At a glance

Duration: A few minutes for sampling; results the same day or within a few days depending on the assays

Preparation: Required

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