A Patient with Persistent Lactation and Recurrent Hypercalcemia

Meng, Qing H.; Wagar, Elizabeth A.

doi:10.1373/clinchem.2014.234849

Cited by 1 publication

(1 citation statement)

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“…Patients on proton pump inhibitor (PPI) were excluded from CgA and gastrin analysis because of the known association of higher CgA and gastrin levels with chromic PPI administration. [16][17][18] Patients with synchronous thymic, lung or gastric NETs were also excluded from CgA analysis because of the potential for a higher CgA level in these patients. 19 For PNET patients, the most recent laboratory measurement within 3 months prior to the PNET diagnosis was chosen.…”

Section: Study Subjectsmentioning

confidence: 99%

Utility of chromogranin A, pancreatic polypeptide, glucagon and gastrin in the diagnosis and follow‐up of pancreatic neuroendocrine tumours in multiple endocrine neoplasia type 1 patients

Qiu

Christakis

Silva

et al. 2016

Clinical Endocrinology

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Objective Pancreatic neuroendocrine tumors (PNETs) are the major source of disease-specific mortality in multiple endocrine neoplasia type 1 (MEN1) patients. Chromogranin A (CgA), pancreatic polypeptide (PP), glucagon, and gastrin have some diagnostic value in sporadic PNETs, but there is very little evidence for their efficacy in diagnosing PNETs in MEN1 patients. Design We performed a retrospective chart review of the existing MEN1 database in our institution. Patients One hundred thirteen patients were eligible for diagnostic value analysis of tumor markers. Patients were excluded if measurement of tumor markers was missing, either 3 months prior to PNETs diagnosis (PNETs patients) or prior to abdominal imaging (non-PNETs patients). Measurements Clinicopathologic characteristics and of tumor marker measurements were analyzed. Results Of 293 confirmed MEN1 cases, 55 PNETs and 58 non-PNETs met inclusion criteria. The area under the curve (AUC) for CgA, PP, glucagon, and gastrin in MEN1 cases was 59.5%, 64.1%, 77.0%, and 75.9%, respectively. The AUC for the combination of CgA, PP, and gastrin was 59.6%. PP, but not CgA, glucagon or gastrin was significantly associated with both age and PNETs functional status (P=0.0485 and 0.0188, respectively). No markers were significantly associated with sex, PNETs tumor size, tumor number, tumor location, AJCC (American Joint Committee on Cancer) stage, presence of lymph node metastasis, lymphovascular invasion, or overall survival. CgA values were not significantly lower following PNETs resection than pre-operatively (P=0.554). Conclusions The value of blood markers for diagnosing PNETs in MEN1 patients is relatively low, even when used in combination.

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