Test Id : INHA
Inhibin A, Tumor Marker, Serum
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of patients with granulosa cell tumors of the
Monitoring of patients with granulosa cell tumors and epithelial
Method Name
A short description of the method used to perform the test
Immunoenzymatic Assay
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Specimen Type
Describes the specimen type validated for testing
Serum
Ordering Guidance
For the initial evaluation of patients suspected of having a granulosa cell tumor of the ovary, order INHAB / Inhibin A and B, Tumor Marker, Serum. If the results of the profile show that either inhibin A or B are elevated, consider monitoring the patient with the individual tests, INHA / Inhibin A, Tumor Marker, Serum or INHB / Inhibin B, Serum.
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.5 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Ambient | 7 days | ||
| Frozen | 90 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Aiding in the diagnosis of patients with granulosa cell tumors of the
Monitoring of patients with granulosa cell tumors and epithelial
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Inhibins are heterodimeric protein hormones secreted by granulosa cells of the ovary and Sertoli cells of the testis. They selectively suppress secretion of pituitary follicle stimulating hormone and have local paracrine actions in the gonads. The inhibins consist of a dimer of 2 homologous subunits, an alpha subunit and either a beta A or beta B subunit, to form inhibin A and inhibin B, respectively.
In female individuals, inhibin A is primarily produced by the dominant follicle and corpus luteum; whereas inhibin B is predominantly produced by small developing follicles. Serum inhibin A and B levels fluctuate during the menstrual cycle. At menopause, with the depletion of ovarian follicles, serum inhibin A and B decrease to very low or undetectable levels.
Ovarian cancer is classified into 3 types: epithelial, stromal sex cord, and germ cell tumors. Epithelial ovarian tumors account for 90% of cases and are further subdivided into serous (70%), mucinous (10%-15%), and endometrioid (10%-15%) types. Granulosa cell tumors represent the majority of the stromal sex cord tumors, which account for 2% to 5% of all ovarian tumors.
Elevations of serum inhibin A and B are detected in some patients with granulosa cell tumors. Inhibin A elevations have been reported in approximately 70% of granulosa cell tumors. In these patients, inhibin A levels tend to show a 6-fold to 7-fold increase over the reference range value. The frequency of elevated levels varies amongst studies, likely due to the different specificities of the antibodies used in the immunoassays.
Inhibin A also appears to be a suitable marker for epithelial tumors of the mucinous type with about 20% of cases having elevated inhibin A levels. In contrast, inhibin is not a very good marker in nonmucinous epithelial tumors. At best, total inhibin is elevated in 15% to 35% of nonmucinous epithelial ovarian cancer cases.
Inhibin seems to be complementary to cancer antigen 125 (CA 125) as an ovarian cancer marker. CA 125 is not as good of a tumor marker for mucinous and granulosa ovarian cell tumors. Inhibin shows a better performance in those 2 types of ovarian cancer.
The majority of studies for inhibin A and B as ovarian cancer markers have been limited to postmenopausal women where the levels for both proteins are normally very low. Inhibin A has limited utility as an ovarian cancer marker in premenopausal women, where circulating levels are higher and fluctuate throughout the menstrual cycle and, therefore, are difficult to interpret.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Males: <5.0 pg/mL
Females
<11 years: <5.0 pg/mL
11-17 years: <98 pg/mL
Premenopausal: <98 pg/mL
Postmenopausal: <5.0 pg/mL
Interpretation
Provides information to assist in interpretation of the test results
Inhibin A levels are elevated in approximately 70% of patients with
For monitoring of patients with known ovarian cancer, inhibin A
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Inhibin values fluctuate during the menstrual cycle. Inhibin levels in premenopausal women should be interpreted with caution.
Do not interpret serum inhibin levels as absolute evidence of the presence or the absence of malignant disease. Use results in conjunction with information from the clinical evaluation of the patient and other diagnostic procedures.
Tumor markers are not specific for malignancy and values may vary by testing methodology. The same method should be used to serially monitor patients.
In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. Caution should be used in interpretation of results and the laboratory should be alerted if the result does not correlate with the clinical presentation.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Mom CH, Engelen MJA, Willemse PHB, et al. Granulosa cell tumors of the ovary: the clinical value of serum inhibin A and B levels in a large single center cohort. Gynecol Oncol. 2007;105(2):365-372
2. Robertson DM, Pruysers E, Jobling T. Inhibin as a diagnostic marker for ovarian cancer. Cancer Lett. 2007;249(1):14-17
3. Jamieson S, Fuller PJ. Management of granulosa cell tumour of the ovary. Curr Opin Oncol. 2008;20(5):560-564
4. Sturgeon C. Tumor markers. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:436-478
5. Yarbrough ML, Stout M, Gronowski AM. Pregnancy and its disorders. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1655-1696
6. Makanji Y, Zhu J, Mishra R, et al. Inhibin at 90: from discovery to clinical application, a historical review. Endocr Rev. 2014;35(5):747-794. doi:10.1210/er.2014-1003
7. Walentowicz P, Krintus M, Sadlecki P, et al. Serum inhibin A and inhibin B levels in epithelial ovarian cancer patients. PLoS One. 2014;9(3):e90575. doi:10.1371/journal.pone.0090575
Method Description
Describes how the test is performed and provides a method-specific reference
The assay is performed using a Beckman Coulter Unicel DXI 800. The Access Inhibin A assay is a sequential 2-step immunoenzymatic ("sandwich'') assay. Sample is added to a reaction vessel and incubated with paramagnetic particles coupled with anti-inhibin A monoclonal antibody. Excess sample and reagents are removed, and anti-inhibin A monoclonal antibody-alkaline phosphatase conjugate is then added to a reaction mixture. After incubation, unbound materials are washed away. Antibody-analyte complex is detected by addition of the chemiluminescent substrate. The light production is directly proportional to the concentration of inhibin A in the sample.(Package insert: Access Inhibin A. Beckman Coulter Inc; 10/2023)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
86336
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| INHA | Inhibin A, Tumor Marker, S | 23883-2 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| INHA | Inhibin A, Tumor Marker, S | 23883-2 |