As one of the largest providers of laboratory testing services in Canada, Gamma-Dynacare is at the forefront of offering and bringing you information about innovations and test technologies to assist in the screening, diagnosis and treatment of disease.
For more information about the featured tests described below, please consult the Test Information or Contact Us sections of this web site. Patients should consult with your healthcare provider to determine which tests are appropriate for you.
Cervical cancer occurs when the cells of the cervix change in a way that leads to abnormal growth and eventually invasion of other tissues or organs of the body. Typically these changes progress slowly from normal cervical tissue to precancerous (or dysplastic) changes in the tissue, to invasive cancer.
The Pap test is used to detect precancerous and cancerous changes so that appropriate treatment can be initiated in order to prevent the development of cervical cancer. Gamma-Dynacare uses liquid-based specimen preparation techniques which reduce the number of unsatisfactory Pap tests and also provide greater sensitivity in the detection of abnormalities. The use of new-generation automated screening instruments further enhances the ability of our skilled cytotechnologists to detect abnormalities ensuring appropriate follow-up and earliest possible intervention. For more information, please see our Health Bulletin [PDF].
Cervical cancer is caused by persistent infection with certain oncogenic (cancer-causing) strains of the human papillomavirus (HPV). These viral infections are known to cause progressive cervical cell changes over time and can eventually result in cancer if the virus is not cleared by the body’s immune system or appropriate treatment. The HPV virus -- for which there are usually no symptoms -- is infectious and can be transmitted sexually or through skin-to-skin contact. Gamma-Dynacare offers an FDA-approved screening test, the Digene HPV DNA Assay, for the detection of high-risk strains of HPV. It uses advanced technology to detect the genetic sequence of HPV strains that can cause cervical cancer. The test is recommended for patients aged 30 or over [when cervical cancer due to persistent HPV infection is most likely to occur] if the Pap result is unclear or abnormal. For more information, please see our HPV Fact Sheet [PDF]
PSA (Prostate-Specific Antigen)
PSA testing is important for diagnosing and monitoring treatment and for estimating the prognosis in prostate cancer. Elevated PSA levels can also indicate benign conditions such as benign prostatic hypertrophy (BPH) and prostatitis. Indeed, 20% of patients with prostate cancer have total PSA < 4.0 µg/L, and only 25% of patients with PSA > 4.0 µg/L have prostate cancer.
The clinical specificity of PSA testing is greatly improved with the measurement of the ratio of free PSA (fPSA) to total PSA (fPSA ratio). If the fPSA ratio > 0.25, there is only a 10% chance of prostate cancer. If the fPSA ratio < 0.10, there is a 90% chance of prostate cancer. Use of this test reduces the number of “unnecessary” (i.e., negative) biopsies by about 20% with only a small risk (5–10%) of missing a cancer that might be present.
Carbohydrate antigen CA 125 is a protein biomarker that is encoded by the MUC16 gene. Its concentration is elevated in many benign and malignant diseases, including cancer of the ovary. Its main use is to monitor chemotherapy and prognosis in patients with a diagnosis of ovarian cancer. There are some studies suggesting that it can also be used to screen post-menopausal women for ovarian cancer.
This is a carbohydrate antigen that is present in several gastrointestinal (GI) tissues. Its concentration in serum is greatly elevated in cancers of the GI tract, most notably of the pancreas and the stomach. It is helpful both as a diagnostic and as a prognostic test for pancreatic cancer. Results greater than 10,000 U/mL are virtually always the result of pancreatic cancer.
CA 27-29 and CA 15-3 (Breast)
These are mucin glycoproteins found mainly in breast tissue. Concentrations are frequently elevated in breast cancer. Both CA 27-29 and CA 15-3 are more sensitive and more specific for breast cancer than CEA. Their main use is to monitor treatment of Stage II or III breast cancer being treated with chemotherapy.
Allergy can be a complex disease presenting with many symptoms that can quite often be misdiagnosed. Allergy is also a dynamic disease that is constantly changing and progressing. For some individuals, when exposed to the triggers, called allergens, the immune system may mistakenly believe these substances harmful to the body and produce antibodies, causing allergic reactions that occur in the person’s eyes, nose, throat, lungs or gastrointestinal tract. It is important to avoid or minimize exposure to these allergens as one’s condition may worsen over time. If left undiagnosed, allergies may have a profound effect on physical and emotional quality of life.
The ImmunoCAP® IgE blood test is a safe and reliable procedure that is part of a diagnostic regime to identify IgE-mediated disorders without exposing patients to allergens. There are more than 300 allergens available, including specific food, inhalant and environmental allergens. A single, convenient blood test can test up to 40 allergens with no patient preparation necessary and can be used effectively for infants, children or adults. There is also no interference if the patient is on medication. A list of the allergens offered for testing is available by contacting Customer Service at Gamma-Dynacare. For more information, please see our allergy testing brochure for patients, Is It Allergy? [PDF] or for healthcare providers, Allergy Testing: Supporting You in Your Diagnosis [PDF].
Food IgG intolerance testing
It has been long known that consumption of certain foods can have a profound effect on the physical and mental health of susceptible individuals. It has been identified that food-specific IgG antibodies (produced by the body’s immune system) and symptoms of food intolerance are closely linked. Food intolerance is often associated with a wide range of unpleasant symptoms and many chronic conditions. Unlike food allergies, food intolerance is unlikely to be life-threatening. Symptoms can include respiratory or gastrointestinal disorders, migraines, headaches or dermatological problems such as eczema. The symptoms are often delayed and can appear up to three days after eating the offending food. Therefore it can be very difficult to pinpoint the offending food. Dietary management based on the identification of food sensitivities is associated with significant and rapid improvement in the symptoms for approximately 71–78% of people.
The Food Intolerance Test is the first step in the process to help identify the foods which may be causing symptoms. Gamma-Dynacare utilizes a microarray-based test that can detect IgG antibodies to more than 200 different foods. Based on test results, patients should work with their Health Professionals to determine which foods should be eliminated or reduced from their diets. Once the symptoms subside, the foods may be re-introduced one by one and the effects monitored. For more information, please see our Food Intolerance Test brochure [PDF]
Celiac Disease (CD) markers
Celiac disease (CD) is a relatively common autoimmune disease with a genetic component and an environmental trigger. In people with CD, eating gluten, a protein found in wheat, rye and barley can set off an auto-immune response that damages or destroys the villi – the tiny protrusions lining the small intestine, that allow for nutrients from food to be absorbed through the walls of the intestine into the bloodstream. This can lead to patients being malnourished or having other complications. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins and lip balms.
Diagnosis of celiac disease can be difficult as the symptoms can be varied and are similar to those of other diseases. As a result, celiac disease has often been under or misdiagnosed. Blood tests can add valuable diagnostic information. Gamma-Dynacare’s current celiac panel consists of IgA Tissue Transglutaminase, Endomysial and Gliadin IgA / IgG antibodies. It is important that patients continue to eat a normal, gluten-containing diet before being tested. If symptoms and blood tests are suggestive of celiac disease, a small biopsy of the small intestine is performed to confirm diagnosis.
Rheumatoid Arthritis (RA) and CCP antibodies
Rheumatoid Arthritis (RA) is a chronic, inflammatory autoimmune disorder characterized by joint inflammation that can quite often lead to joint destruction. It is the most common inflammatory joint disease, affecting approximately 1–2% of the world population. Diagnosis of the disease is primarily based upon clinical manifestations. Earlier diagnosis of the disease can lead to better treatment strategies and often better quality of life.
Recent studies have shown that antibodies to cyclic citrullinated peptide (CCP) appear to be highly specific for RA in early detection of the disease. In earlier stages of the disease, symptoms are usually milder and non-specific. CCP antibodies have been detected in approximately 50 – 60% of patients at baseline diagnosis, or at first visit with a specialist. One other study showed 70% of such patients. Observations have indicated that anti-CCP positive patients in early diagnosis may develop a more erosive disease than those anti-CCP negative patients. The use of the anti-CCP test may allow for better prediction of the diagnosis and prognosis of patients with RA.
Anti-Cardiolipin Antibodies (ACA)
The clinical complications associated with the presence of anti-cardiolipin antibodies (ACA), collectively known as anti-phospholipid syndrome, are: venous and arterial thrombosis, thrombocytopenia, and recurrent fetal loss or premature births. This syndrome may be primary or secondary in association with other autoimmune conditions such as systemic lupus erythematosus and other systemic autoimmune disorders. High levels of ACA in patients after survival of a myocardial or cerebral infarction may be an indication of an elevated risk of further vascular complications. Auto-antibodies to cardiolipin belong to the immunoglobulin subclasses IgM, IgA and IgG of which IgM has the greatest diagnostic relevance.
Fructosamine is a time-averaged indicator of blood glucose levels and is used to access the glycemic status of diabetics. The concentration of glycated protein such as glycohemoglobin, glycoalbumin or glycated total protein is generally recognized to be valuable in evaluating the glycemic status of diabetic patients.
The turnover of serum proteins (albumin has a half-life of 19 days) is less than that of hemoglobin (life-span of erythrocytes is approximately 120 days), and therefore fructosamine determinations provide a means of monitoring patient blood glucose status over a shorter period (1–3 weeks) than glycohemoglobin (6-8 weeks). As a result, changes in fructosamine values alert the healthcare provider to deteriorating glycemic control earlier than the changes in HbA1c values. In addition, fructosamine levels decrease more quickly than HbA1c when diabetic patients are brought under better control.
Alcohol Abuse Markers
Whole Blood Associated Acetaldehyde (WBAA) / Hemoglobin Associated Acetaldehyde
Whole blood associated acetaldehyde (WBAA) assay is a specific confirmation test that distinguishes alcohol-related from non alcohol-related liver enzyme elevations. It may be useful in detecting chronic alcohol abuse, in conjunction with other findings, which are indicative of excessive alcohol intake.
Acetaldehyde is a major metabolite of ethanol. Excessive alcohol intake causes acetaldehyde to be chronically present at elevated levels in the blood. Acetaldehyde at these high levels attaches to blood proteins, creating elevated WBAA concentrations. WBAA is measured using an EDTA-preserved whole blood specimen.
Carbohydrate-Deficient Transferrin (CDT)
Carbohydrate-deficient transferrin (CDT) is a specific marker that will aid healthcare providers and specialists in the recognition of patients with chronically high alcohol consumption over a long period of time. Physicians and specialists will be able to observe changes in alcohol consumption and monitor for changes. The calculation of % CDT from CDT and transferrin concentrations enables the influences of transferrin levels, iron status and mild to moderate limitations of liver function on the CDT result to be minimized.
Bioavailable Testosterone (BioT)
Bioavailable testosterone (BioT) testing is currently recognized as important in determining clinically significant testosterone levels in both males and females. Both total testosterone and free testosterone measurements lack clinical diagnostic accuracy.
Low BioT production is a significant feature of andropause, the diagnosis of which could indicate the need for hormone replacement therapy for males.
Macroprolactin is a high molecular mass complex of prolactin and IgG immunoglobulin. It is important because elevated serum prolactin, hyperprolactinemia, may be caused by the presence of macroprolactin in the circulation. Macroprolactin is biologically inactive in vivo and is not indicative of pituitary disease. However, macroprolactin is immunoreactive and is detected in many prolactin immunoassays with a potential for misdiagnosis and mismanagement of patients suspected of abnormal prolactin production, as in prolactinomas. Gamma-Dynacare’s macroprolactin assay can help distinguish between true hyperprolactinemia and falsely elevated levels due to biologically inactive macroprolactin.
Leptin is a small polypeptide hormone produced specifically by adipose (fat) tissue that affects food intake, energy expenditure and body weight. It is a product of the ob gene and defects in this gene can lead to markedly increased adipose tissue mass. Expression of the ob gene is quite prevalent and serum or plasma leptin levels are high in obese humans. Although the actual mechanism is unknown, it is believed that obese individuals are resistant to leptin action. Studies have shown that serum leptin levels correlate positively with body mass index or % body fat, as well as with high serum insulin levels. Hence serum or plasma leptin is used in the assessment of obesity and body fat distribution. Mean levels in women are higher than in men.
The test provided by Gamma-Dynacare is the human leptin RIA assay supplied by LINCO Research, 6 Research Park Drive, St. Charles, Missouri, USA, developed for quantifying Human Leptin in plasma, serum and tissue culture media. The test is a complete homologous assay.
It is recommended that individuals should fast for a minimum of 8 hours before blood is drawn for testing. The test is currently offered for clinical trials and non-diagnostic purposes, as it is not approved for use in diagnosis.
IGF-1: Insulin-like Growth Factor 1 (Somatomedin C)
Measurement of IGF-1 will assist physicians and specialists in the identification and diagnosis of diseases and conditions caused by deficiencies and overproduction of growth hormone. In humans, plasma IGF-1 levels are barely detectable at birth, rise gradually during childhood, peak during mid-puberty until approximately 40 years of age, then decline gradually. Maternal plasma levels increase during pregnancy. In the diagnosis of growth disorders, measurements of IGF-1 are a useful indicator of growth hormone (GH) secretion. A normal plasma or serum IGF-1 concentration is strong evidence against GH deficiency. A low IGF-1 value implies GH deficiency and requires additional testing to determine whether GH secretion is subnormal. Measurement of IGF-1 is also useful in assessing change of nutritional status.
Gamma-Dynacare offers trace metal testing through our specialty testing laboratory facility utilizing the very latest technology in trace metal testing, including Inductive Coupled Plasma – Mass Spectrometry (ICP-MS). Together with our comprehensive analysis techniques, we deliver:
- Better quality and more accurate results;
- Enhanced turn-around-time (TAT);
- An expanded menu of trace metal elements; and
- Customized reports based on client needs.
We offer testing on the following elements:
Blood samples are whole bloods, plasma or serum. A random urine sample is recommended for monitoring long-term exposure and a 24-hour urine sample is recommended for management and treatment of over-exposure. Results are reported as per the relevant Ministry of Labour guidelines. Age-related reference ranges are considered when looking at deficiencies, particularly in children.
In general, HIV Ag/Ab Combo assays are referred to as fourth (4th) Generation HIV assays. Combo assays simultaneously detect p24 Ag (antigen) and anti-HIV-1/2 Ab (antibodies), which allow for the early detection and ongoing monitoring of the virus. Third generation anti-HIV and other conventional assays do not detect the p24 antigen and therefore lack the ability for early detection of HIV infection. The assay used by Gamma-Dynacare is the Abbott Diagnostics ARCHITECT Ag/Ab Combo Assay. It is a qualitative assay which simultaneously detects human immunodeficiency virus (HIV) p24 antigen and antibodies to HIV type 1 (HIV 1 group M and group O) and/or type 2 (HIV-2) in adult and pediatric serum and plasma. The assay is intended for use in the diagnosis of HIV-1/HIV-2 infection, including acute or primary HIV-1 infection and in pregnant women.
QuantiFERON-TB Gold In-Tube is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography and other medical and diagnostic evaluations. This test offers many benefits over conventional TB skin testing including:
- superior specificity and sensitivity, eliminating false positive results caused by BCG vaccination and non-tuberculosis mycobacterium infection;
- convenience – single patient visit only;
- safe – no possibility of adverse reactions in hypersensitive people; and
- results ready within 7 to 10 days.
Neisseria gonorrhoeae and Chlamydia trachomatis detection
Gamma-Dynacare now uses molecular technology for detecting these organisms. The change from conventional culture for N. gonorrhoeae and Chlamydia testing to the molecular assays, offers state-of-the-art technology for detection of these STD agents. The GenProbe Nucleic Acid Transcription Mediated Amplification (TMA) assay targets and subsequently amplifies unique nucleic acid sequences of these two pathogens. TMA technology performs with overall sensitivity of 96.1% and specificity of 98.0%.
Both tests can be performed utilizing a single collection device/sample − either the GenProbe Unisex swab or a urine sample. Since the assay is based on detection of Nucleic Acid, no viable micro-organisms are necessary for testing.
This assay detects antibodies to Human T-cell Lymphotropic Virus types I and II (HTLV-I/HTLV-II) which are human RNA retroviruses. These viruses are transmitted by sexual contact, exposure to blood (sharing contaminated needles or syringes), transfusion of blood products, from an infected mother to her fetus during the prenatal period or after birth through breast milk. HTLV-I has been associated with adult T-cell leukemia and a variety of demyelinating neurologic disorders such as arthritis and infective dermatitis. HTLV-II has been associated with rare lymphoproliferative disorders such as Hairy Cell leukemia and neurodegenerative disorders although its etiological role remains to be clearly established.
Cytomegalovirus (IgG / IgM)
Cytomegalovirus (CMV) is a common human viral pathogen which belongs to the herpes group of viruses. The presence of CMV antibodies suggests a prior infection by the virus and the possibility that viral reactivation can occur in these individuals. Viral transmission may occur through transfusion of blood or transplantation of organs from seropositive donors. CMV may also be transmitted through close intimate contact with an infected person and is transmitted in urine, saliva, breast milk, cervical secretions, and semen during primary and re-activated infections. Gamma-Dynacare offers a qualitative screen for the presence of both IgG and IgM antibodies.
Urea breath test for diagnosis of Helicobacter Pylori
This non-invasive test requires only a breath sample after the patient swallows a urea capsule. It is an excellent test to determine whether there is an active infection or whether the infection has been eradicated by treatment. The serological H. pylori test does not determine the difference between the live and dormant organism, whereas the breath test detects only live H. pylori. Current practice guidelines recommend this breath test.
Even a moderately increased concentration of homocysteine is an independent risk factor for arteriosclerosis. The risk increases as homocysteine concentrations increase, even within the reference interval, but especially over 15 µmol/L. Treatment with folic acid has been demonstrated to decrease homocysteine in the blood. This test should be considered for patients with a strong family or personal history of heart disease, stroke or excessive coagulation without other risk factors.