Chromogranin A as an Alternative to 5-Hydroxyindoleacetic Acid in the Evaluation of Symptoms during Treatment of Patients with Neuroendocrine Tumors

Abstract

Background: Urinary 5-HIAA excretion is a well-known marker in neuroendocrine tumors (NETs), but it has a low sensitivity and the 24-hour collection is inconvenient for patients. Chromogranin A (CgA) is a promising marker, but a thorough evaluation during follow-up is still lacking. Methods: 39 patients with metastatic gastrointestinal NETs were monitored during treatment with the long-acting octreotide SandostatinLAR®. A comparison was made between serum CgA and urinary 5-HIAA in relation to quality of life (HRQL) assessed by the EORTC QLQ-C30 questionnaire, supplemented with questions specific to carcinoid symptoms. Survival analyses were performed to examine the association between the markers and survival time. Results: Correlations were found between CgA and physical functioning (p = 0.01) and quality of life (p = 0.03), while no significant correlations were observed between 5-HIAA levels and any of the self-reported health outcomes. Cox regression showed an association between CgA levels and survival time (p = 0.02), while no significant association was observed between 5-HIAA levels and survival time. Conclusion: Stronger correlations of CgA compared to 5-HIAA with physical functioning and wellbeing, the convenience of measuring in blood, as well as the prognostic value of CgA for survival, makes CgA the recommended marker in the management of patients with metastatic NETs.

The role of chromogranin-A and its derived peptide, WE-14 in the development of type 1 diabetes mellitus

“…A különböző endokrin szö-vetekben proteolitikus módosításokat követően alakul át extracellulárisan működő biológiailag aktív peptidformákká. A CgA-ból kialakuló fehérjék, mint a pancreastatin, a vasostatin, a WE-14 és további formák jelentős és specifi kus biológiai hatással rendelkeznek (1. táblázat) [26,27,28,29,30,34,35,45,47,48,49,50,51,52].…”

Comparison of Chromatographic Methods for Determination of the Major Metabolites of Catecholamines and Serotonin

“…But sometimes, in severe hypertension and nonnoticeable other symptoms, it is mistaken for a hypertensive crisis. Such attacks are also observed in mastocytosis, as well as in thyroid cancer in women [14].…”

GEP-NETs UPDATE: Secreting gastro-enteropancreatic neuroendocrine tumours and biomarkers

“…The CgA molecule can exist in different molecular forms, depending on the type of NE cells and its concerning tumour (24). Therefore, the CgA result, measured in serum or plasma, is dependent of the (25), tend to correlate with tumour burden as well as recurrence and are considered a marker of bad prognosis in both ileal and pancreatic NET (26,27,28). The sensitivity of the CgA results is around 60-80% and is dependent of primary site, grade and status of the disease (29).…”

“…Stronger correlations of CgA compared to 5-HIAA with physical functioning and well-being, as well as the prognostic value of CgA for survival, make CgA the recommended marker in the management and monitoring response to various treatment strategies of patients with metastatic NETs (28). Unfortunately, however, CgA also has its limitations, as various assays are available and an international standardization is lacking.…”