{"id":10109,"date":"2020-04-23T03:56:49","date_gmt":"2020-04-23T01:56:49","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/cromogranina-a\/"},"modified":"2025-02-07T09:15:13","modified_gmt":"2025-02-07T07:15:13","slug":"cromogranina-a","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/cromogranina-a\/","title":{"rendered":"\u0425\u0440\u043e\u043c\u043e\u0433\u0440\u0430\u043d\u0438\u043d \u0410"},"content":{"rendered":"

Informa\u0163<\/em><\/strong>ii generale <\/em><\/strong><\/span><\/p>\n

Cromogranina A este o protein\u0103 cu greutatea molecular\u0103 de 49 kD alc\u0103tuit\u0103 din 439 aminoacizi. Face parte din familia graninelor care se g\u0103sesc \u00een veziculele secretorii ale celulelor neuroendocrine. Rolul acestora este de a regla activitatea secretorie a acestor celule.<\/span><\/p>\n

Datorit\u0103 r\u0103sp\u00e2ndirii ubicuitare \u00een \u0163esuturile neuroendocrine, cromogranina A constituie un marker util pentru tumorile dezvoltate din aceste \u0163esuturi: carcinoid, feocromocitom, neuroblastom, carcinom tiroidian medular, unele tumori hipofizare, tumori insulare pancreatice \u015fi alte apudoame. A fost demonstrat faptul c\u0103 nivelurile serice de cromogranin\u0103 A se coreleaz\u0103 cu volumul tumoral. De asemenea reprezint\u0103 un instrument sensibil pentru depistarea tumorilor reziduale \u015fi a recuren\u0163elor la pacien\u0163ii trata\u0163i.<\/span><\/p>\n

\u00cen special tumorile carcinoide secret\u0103 cromogranina A al\u0103turi de serotonin\u0103 \u015fi peptide. Acestea sunt clasificate \u00een func\u0163ie de locul de origine a tumorii \u00een:<\/span><\/p>\n

\u2013 tumori derivate din partea cranial\u0103 a tubului digestiv primitiv: pancreatice, duodenale, gastrice, bron\u015fice;<\/span><\/p>\n

\u2013 tumori derivate din partea medial\u0103 a tubului digestiv primitiv: jejunale, ileale \u015fi la nivelul apendicelui;<\/span><\/p>\n

\u2013 tumori derivate din partea caudal\u0103 a tubului digestiv primitiv: \u00een colonul ascendent \u015fi rect;<\/span><\/p>\n

\u2013 tumori cu alte origini: timice, ovariene, renale, mamare.<\/span><\/p>\n

Mai exist\u0103 o categorie de tumori care nu \u00ee\u015fi au originea\u00a0\u00een \u0163esuturile neuroendocrine clasice, dar con\u0163in celule cu diferen\u0163iere neuroendocrin\u0103 par\u0163ial\u0103, cum ar fi carcinomul pulmonar cu celule mici sau carcinomul de prostat\u0103,\u00a0\u00een care se \u00eenregistreaz\u0103 valori crescute de cromogranina A\u00a0\u00een ser2;3<\/sup>.<\/span><\/p>\n

Recomand\u0103ri pentru determinarea cromograninei A<\/em><\/strong><\/span><\/p>\n

\u2013 diagnosticul tumorilor carcinoide (cromogranina A constituie un marker de prim\u0103 linie pentru diagnostic, ca alternativ\u0103 sau \u00een asociere cu determin\u0103rile de 5-HIIA urinar, serotonina seric\u0103 \u015fi urinar\u0103);<\/span><\/p>\n

\u2013 marker de prima linie (\u00eempreun\u0103 cu 5-HIIA) pentru monitorizarea pacien\u0163ilor cu tumori carcinoide;<\/span><\/p>\n

\u2013 marker adjuvant pentru diagnosticul altor tumori neuroendocrine: feocromocitom, neuroblastom, carcinom tiroidian medular, unele tumori hipofizare, tumori insulare pancreatice \u015fi alte apudoame;<\/span><\/p>\n

\u2013 posibil marker adjuvant pentru monitorizarea pacien\u0163ilor cu carcinom prostatic avansat2<\/sup>.<\/span><\/p>\n

Preg\u0103tire pacient <\/em><\/strong>- <\/em>Pacientul va \u00eentrerupe medicamentele din categoria inhibitorilor de pomp\u0103 de protoni (ex. omeprazol) cu 1 s\u0103pt\u0103m\u00e2n\u0103 \u00eenaintea recolt\u0103rii1;3<\/sup>.<\/span><\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c1<\/sup>.<\/span><\/p>\n

Recipient de recoltare <\/em><\/strong>- <\/em>vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator1<\/sup>.<\/span><\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare<\/em><\/strong> \u2013 se separ\u0103 serul prin centrifugare<\/span><\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 minim 2 mL ser1<\/sup>.<\/span><\/p>\n

Cauze de respingere<\/em><\/strong> a probei<\/em><\/strong><\/span><\/p>\n

\u2022 specimen hemolizat;<\/span><\/p>\n

\u2022 specimen expus la temperatur\u0103 ridicat\u0103;<\/span><\/p>\n

\u2022 specimen contaminat bacterian1<\/sup>.<\/span><\/p>\n

Stabilitate prob\u0103 <\/em><\/strong>- <\/em>Timp de 2 zile la 2-8\u00b0C sau timp \u00eendelungat la -20\u00b0C.<\/span><\/p>\n

Metod\u0103 <\/em><\/strong>- <\/span>metoda imunochimic\u0103 ce utilizeaz\u0103 tehnologia TRACE (Time Resolved Amplified Cryptate Emission)<\/u>.<\/span><\/span><\/p>\n

Valori de referin\u0163\u0103<\/em><\/strong>1<\/sup> \u2013 <101.9 ng\/mL1<\/sup>.<\/span><\/p>\n

Interpretarea rezultatelor<\/em><\/strong><\/span><\/p>\n

Valorile cromograninei A sunt crescute la majoritatea pacien\u0163ilor cu tumori carcinoide simptomatice, de obicei de c\u00e2teva ori fa\u0163\u0103 de limita superioar\u0103 a normalului. Determin\u0103rile serice sunt \u00een special utile \u00een cazul tumorilor derivate din partea caudal\u0103 a tubului digestiv primitiv, la care nivelurile de serotonin\u0103 \u015fi 5-HIIA sunt adesea normale. La pacien\u0163ii cu tumori derivate din partea cranial\u0103 \u015fi partea medial\u0103 a tubului digestiv primitiv cromogranina A este crescut\u0103 \u00een 80-90% din cazuri.<\/span><\/p>\n

Pentru a atinge sensibilitatea maxim\u0103 \u00een diagnosticul ini\u0163ial al tumorilor carcinoide se recomand\u0103 determinarea concomitent\u0103 a cromograninei A, 5-HIIIA urinar \u015fi a serotoninei serice. Dac\u0103 nici unul din cei 3 parametri nu prezint\u0103 valori crescute, se poate exclude \u00een majoritatea cazurilor un carcinoid. Excep\u0163ie fac unele tumori derivate din partea cranial\u0103 a tubului digestiv primitiv care produc numai 5-hidroxitriptofan \u015fi la care doar serotonina urinar\u0103 prezint\u0103 valori crescute.<\/span><\/p>\n

Evolu\u0163ia bolii la pacien\u0163ii cu tumori carcinoide secretante de serotonin\u0103 poate fi monitorizat\u0103 prin determinarea acesteia \u00een ser. Cu toate acestea, \u00een cazul unor valori mai mari de 5000 \u03bcg\/L capacitatea de stocare a trombocitelor este dep\u0103\u015fit\u0103, iar concentra\u0163iile serice ale serotoninei nu mai sunt direct propor\u0163ionale cu volumul tumoral. Din acest motiv, determin\u0103rile de cromogranin\u0103 A \u015fi 5-HIIA sunt mai utile dec\u00e2t cele ale serotoninei serice. Datorit\u0103 unei rela\u0163ii lineare \u00eentre cromogranina A \u015fi volumul tumoral determinarea acesteia are \u015fi valoare prognostic\u0103.<\/span><\/p>\n

La pacien\u0163ii cu tumori neuroendocrine altele dec\u00e2t cele carcinoide valorile cromograninei A sunt adesea crescute al\u0103turi de hormonii specifici \u0163esuturilor de origine. Deoarece cre\u015fterile cromograninei A nu sunt la fel de mari ca \u00een tumorile carcinoide, determinarea produ\u015filor tumorali specifici are sensibilitate mai mare. Cu toate acestea, m\u0103surarea cromograninei A serice devine util\u0103 \u00een situa\u0163iile \u00een care determin\u0103rile hormonale sunt neconcludente, mai ales \u00een cazul feocromocitoamelor \u015fi neuroblastoamelor.<\/span><\/p>\n

Carcinoamele de prostat\u0103 con\u0163in adesea celule cu diferen\u0163iere neuroendocrin\u0103 par\u0163ial\u0103, care secret\u0103 cromogranina A. Nivelul acesteia este \u00een majoritatea cazurilor insuficient pentru a fi folosit ca marker\u00a0\u00een diagnosticul cancerului de prostat\u0103. Totu\u015fi, dac\u0103 pacien\u0163ii av\u00e2nd carcinom de prostat\u0103 \u00eentr-un stadiu avansat prezint\u0103 valori serice crescute de cromogranina A, acest fapt indic\u0103 rezisten\u0163a la terapia antiandrogenic\u0103 \u015fi un prognostic nefavorabil. Aceast\u0103 categorie de pacien\u0163i necesit\u0103 o monitorizare special\u01033<\/sup>.<\/span><\/p>\n

Limite \u015fi interferen\u0163e<\/em><\/strong><\/span><\/p>\n

Deoarece cromogranina A este metabolizat\u0103 hepatic \u015fi excretat\u0103 renal, pacien\u0163ii cu insuficien\u0163\u0103 hepatic\u0103 sau renal\u0103 avansat\u0103 prezint\u0103 adesea valori semnificativ crescute ale cromograninei A, ceea ce-i limiteaz\u0103 utilitatea.<\/span><\/p>\n

\u2022 Medicamentele care stimuleaz\u0103 secre\u0163ia celulelor neuroendocine, \u00een special inhibitorii de pomp\u0103 de protoni, cresc semnificativ valorile cromograninei A serice3<\/sup>.<\/span><\/p>\n

\u00a0<\/span>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n

1. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/div>\n
2. Laboratory Corporation of America. Directory of Services and Interpretive Guide. Chromogranin A, Serum. www.labcorp.com 2010. Ref Type: Internet Communication.<\/span><\/div>\n
3. Mayo Clinic\/Mayo Medical Laboratories. Test Catalog: Chromogranin A. www.mayomedicallaboratories.com.Ref Type: Internet Communication.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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\u0414\u043b\u044f \u0447\u0435\u0433\u043e \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

    \n
  • \u0414\u043b\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438, \u043c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u043d\u0433\u0430 \u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u043f\u0440\u043e\u0433\u043d\u043e\u0437\u0430 \u043f\u0440\u0438 \u043d\u0435\u0439\u0440\u043e\u044d\u043d\u0434\u043e\u043a\u0440\u0438\u043d\u043d\u044b\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u044f\u0445.<\/li>\n<\/ul>\n

    \u041a\u043e\u0433\u0434\u0430 \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u0435\u0442\u0441\u044f \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435?<\/strong><\/p>\n

      \n
    • \u041e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0438 \u0445\u0440\u043e\u043c\u043e\u0433\u0440\u0430\u043d\u0438\u043d\u0430 \u0410 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043f\u0440\u0438 \u043d\u0430\u043b\u0438\u0447\u0438\u0438 \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0430 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u043e\u0432, \u043f\u043e\u0434\u043e\u0437\u0440\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u0432 \u043e\u0442\u043d\u043e\u0448\u0435\u043d\u0438\u0438 \u043d\u0435\u0439\u0440\u043e\u044d\u043d\u0434\u043e\u043a\u0440\u0438\u043d\u043d\u044b\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u0435\u0439: \u0442\u0430\u043a \u043d\u0430\u0437\u044b\u0432\u0430\u0435\u043c\u044b\u0435 \u043f\u0440\u0438\u043b\u0438\u0432\u044b \u2013 \u043f\u043e\u043a\u0440\u0430\u0441\u043d\u0435\u043d\u0438\u0435 \u043a\u043e\u0436\u0438 \u043b\u0438\u0446\u0430 \u0438 \u0448\u0435\u0438, \u0447\u0430\u0441\u0442\u043e\u0435 \u0441\u0435\u0440\u0434\u0446\u0435\u0431\u0438\u0435\u043d\u0438\u0435, \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u0435 \u0430\u0440\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0434\u0430\u0432\u043b\u0435\u043d\u0438\u044f \u0438 \u0431\u043e\u043b\u0438 \u0432 \u043e\u0431\u043b\u0430\u0441\u0442\u0438 \u0441\u0435\u0440\u0434\u0446\u0430, \u0441\u0445\u0432\u0430\u0442\u043a\u043e\u043e\u0431\u0440\u0430\u0437\u043d\u044b\u0435 \u0431\u043e\u043b\u0438 \u0432 \u0436\u0438\u0432\u043e\u0442\u0435, \u0442\u043e\u0448\u043d\u043e\u0442\u0430, \u0440\u0432\u043e\u0442\u0430, \u0434\u0438\u0430\u0440\u0435\u044f, \u043f\u0440\u0438\u0441\u0442\u0443\u043f\u044b \u0443\u0434\u0443\u0448\u044c\u044f (\u0431\u0440\u043e\u043d\u0445\u043e\u0441\u043f\u0430\u0437\u043c). \u0412\u0441\u0435 \u044d\u0442\u0438 \u0441\u0438\u043c\u043f\u0442\u043e\u043c\u044b \u043e\u0431\u0443\u0441\u043b\u043e\u0432\u043b\u0435\u043d\u044b \u0432\u043b\u0438\u044f\u043d\u0438\u0435\u043c \u043d\u0430 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c \u0432\u044b\u0440\u0430\u0431\u0430\u0442\u044b\u0432\u0430\u0435\u043c\u044b\u0445 \u043e\u043f\u0443\u0445\u043e\u043b\u044c\u044e \u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u044b\u0445 \u0432\u0435\u0449\u0435\u0441\u0442\u0432 \u0438 \u0441\u043e\u0441\u0442\u0430\u0432\u043b\u044f\u044e\u0442 \u043a\u0430\u0440\u0446\u0438\u043d\u043e\u0438\u0434\u043d\u044b\u0439 \u0441\u0438\u043d\u0434\u0440\u043e\u043c.<\/li>\n
    • \u041f\u043e\u043c\u0438\u043c\u043e \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u043e\u0439 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0438, \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f \u0445\u0440\u043e\u043c\u043e\u0433\u0440\u0430\u043d\u0438\u043d\u0430 \u0410 \u043f\u0440\u043e\u0432\u043e\u0434\u044f\u0442 \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u0438 \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0437\u0430 \u0440\u0435\u0446\u0438\u0434\u0438\u0432\u043e\u043c \u043e\u043f\u0443\u0445\u043e\u043b\u0438.<\/li>\n<\/ul>\n

      \u041a\u0430\u043a \u043f\u0440\u0430\u0432\u0438\u043b\u044c\u043d\u043e \u043f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u0438\u0442\u044c\u0441\u044f \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e?<\/strong><\/p>\n

        \n
      • \u0418\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0438\u0437 \u0440\u0430\u0446\u0438\u043e\u043d\u0430 \u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044c \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 24 \u0447\u0430\u0441\u043e\u0432 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n
      • \u041d\u0435 \u043f\u0440\u0438\u043d\u0438\u043c\u0430\u0442\u044c \u043f\u0438\u0449\u0443 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 8 \u0447\u0430\u0441\u043e\u0432 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f, \u043c\u043e\u0436\u043d\u043e \u043f\u0438\u0442\u044c \u0447\u0438\u0441\u0442\u0443\u044e \u043d\u0435\u0433\u0430\u0437\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u0443\u044e \u0432\u043e\u0434\u0443.<\/li>\n
      • \u0418\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0444\u0438\u0437\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438 \u044d\u043c\u043e\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0435 \u043f\u0435\u0440\u0435\u043d\u0430\u043f\u0440\u044f\u0436\u0435\u043d\u0438\u0435 \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n
      • \u041d\u0435 \u043a\u0443\u0440\u0438\u0442\u044c \u0432 \u0442\u0435\u0447\u0435\u043d\u0438\u0435 30 \u043c\u0438\u043d\u0443\u0442 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[923],"product_tag":[],"class_list":{"0":"post-10109","1":"product","2":"type-product","3":"status-publish","5":"product_cat-markeri-tumorali","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10109"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10109"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10109"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10109"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}