Elevated chromogranin A (CgA) serum levels in the patients with advanced pancreatic cancer

Malaguarnera, Michele; Cristaldi, Erika; Cammalleri, Lisa; Colonna, Valentina; Lipari, Helga; Capici, Alessandra; Cavallaro, Andrea; Beretta, Massimiliano; Alessandria, I.; Luca, S. De; Motta, Massimo

doi:10.1016/j.archger.2008.01.014

Cited by 32 publications

(20 citation statements)

References 47 publications

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“…These results support the data about low sensitivity of Cr-A in the diagnosis of NET (12). Elevated Cr-A levels can be detected in several malignant and benign conditions such as cardiovascular, gastrointestinal, pulmonary, rheumatologic and endocrine disorders (13)(14)(15)(16). Additionally a group of medications mostly commonly proton pump inhibitors may affect serum Cr-A levels (17).…”

Section: Discussionsupporting

confidence: 78%

Ga-68 DOTATATE positron emission tomography computed tomography findings in patients with neuroendocrine tumor suspicion

Soydal¹,

Ozkan²

2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Aim: We aimed to retrospectively evaluate the outcome of patients with suspected neuroendocrine tumor (NET)s who underwent Ga-68 DOTATATE Pozitrun Emission Tomography/Computed Tomography (PET/CT) imaging and to describe the value of Ga-68 DOTATATE PET/CT in the detection of NETs.Material and Method: Ga-68 DOTATATE PET/CT images of 35 patients (26M; 9F, mean age; 45.2±5.4 years) with suspected NET were analyzed retrospectively. Suspicion of NET was due to clinical symptoms (n:12), elevated biochemical markers (n:19) and/or radiological findings (n:13). Clinical/imaging follow-up and/or histopathological confirmation was used as reference standard.Results: Based on the reference standard 13 of 35 patients had NET. Ga-68 DOTATATE PET/CT was positive in 12 out of 13 patients and it was false negative in 1 patient. Pancreas was the commonest site of the primary tumor. Ga-68 DOTATATE was TP(true pozitive), FP (False Positive), TN (True Negative) and FN (False Negative) in, 12, 2, 20 and 1, patients respectively. Sensitivity, specificity, Pozitive Pedictive Value (PPV), Negative Pedictive Value (NPV), and accuracy of Ga-68 DOTATATE PET/CT was calculated as 85%, 95%, 92%, 90% and 91%, respectively.Conclusion: Ga-68 DOTATATE PET/CT has a high accuracy in the detection of suspected NET. It can be used for searching possible NET in patients with suspicion.

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Section: Discussionsupporting

confidence: 78%

Ga-68 DOTATATE positron emission tomography computed tomography findings in patients with neuroendocrine tumor suspicion

Soydal¹,

Ozkan²

2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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“…A variety of non-NEN malignancies are characterized by increased CgA levels (Glinicki & Jeske 2011). The majority of them present a histological pattern of neuroendocrine differentiation, including several digestive tumors, such as colorectal adenocarcinoma (Syversen et al 1995), gastric and pancreatic cancer (Malaguarnera et al 2009) and prostate adenocarcinoma (Angelsen et al 1997). By contrast, there are some tumors showing CgA elevation where the presence of histological neuroendocrine differentiation has not been reported, such as primary hepatocellular cancer (Spadaro et al 2005) and breast cancer (Giovanella et al 2001).…”

Section: Oncological Causes Of Cga Elevationmentioning

confidence: 99%

“…These include a variety of gastrointestinal disorders, such as chronic atrophic gastritis (CAG) (Peracchi et al 2005), Helicobacter pylori infection (Waldum et al 1996), liver cirrhosis and chronic hepatitis (Spadaro et al 2005), pancreatitis (Malaguarnera et al 2009), inflammatory bowel diseases (Sciola et al 2009) and even irritable bowel syndrome (Sidhu et al 2009). Among cardiovascular diseases, elevated CgA levels have been reported in hypertension, with higher levels being demonstrated in untreated patients (Takiyyuddin et al 1995), chronic heart failure, where more accentuated elevations were detected in the fourth grade of the NHYA scale (Ceconi et al 2002) and acute coronary syndromes, where higher concentrations predicted worsened outcome (Jansson et al 2009).…”

Section: Non-oncological Causes Of Cga Elevationmentioning

confidence: 99%

Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame

Marotta

Zatelli

Sciammarella³

et al. 2018

Endocrine-Related Cancer

117

104

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Owing to the heterogeneity of neuroendocrine neoplasms (NENs), the availability of reliable circulating markers is critical for improving diagnostics, prognostic stratification, follow-up and definition of treatment strategy. This review is focused on chromogranin A (CgA), a hydrophilic glycoprotein present in large dense core vesicles of neuroendocrine cells. Despite being long identified as the most useful NEN-related circulating marker, clinical application of CgA is controversial. CgA assays still lack standardization, thus hampering not only clinical management but also the comparison between different analyses. In the diagnostic setting, clinical utility of CgA is limited as hampered by (a) the variety of oncological and non-oncological conditions affecting marker levels, which impairs specificity; (b) the fact that 30-50% of NENs show normal CgA, which impairs sensitivity. Regarding the prognostic phase, there is prospective evidence which demonstrates that advanced NENs secreting CgA have poorer outcome, as compared with those showing non-elevated marker levels. Although the identification of cut-offs allowing a proper risk stratification of CgA-secreting patients has not been performed, this represents the most important clinical application of the marker. By contrast, based on prospective studies, the trend of elevated circulating CgA does not represent a valid indicator of morphological evolution and has therefore no utility for the follow-up phase. Ultimately, current knowledge about the role of the marker for the definition of treatment strategy is poor and is limited by the small number of available studies, their prevalent retrospective nature and the absence of control groups of untreated subjects.

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“…We evaluated CgB and CgA levels of not only pNET but also other pancreatic diseases, because it has been shown that CgA is influenced by PC and AIP (19,20) and it may be a drawback of CgA. On the other hand, there is a limitation that we could not correct samples of well-matched cases and controls.…”

Section: Discussionmentioning

confidence: 99%

“…However, serum CgA values rise with oral use of proton pump inhibitors (PPIs) (12)(13)(14), and in patients with renal impairment (15), cardiovascular disease (16), inflammatory bowel disease (17), various malignant tumors (18) and other pancreatic diseases, showing false negative results (19,20), as described in previous studies (21,22).…”

Section: Introductionmentioning

confidence: 99%

Utility of chromogranin B compared with chromogranin A as a biomarker in Japanese patients with pancreatic neuroendocrine tumors

Minemura

Ito

Hijioka

et al. 2017

Japanese Journal of Clinical Oncology

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Objective: Currently, serum chromogranin A is a well-established biomarker for pancreatic neuroendocrine tumors; however, other pancreatic diseases, oral use of a proton pump inhibitor and renal impairment can affect chromogranin A. Meanwhile, chromogranin B, belonging to the same granin family as chromogranin A, is not fully examined in these conditions. The present study aimed to evaluate the utility of chromogranin B as a pancreatic neuroendocrine tumor biomarker. Methods: Serum chromogranin B levels were determined by radioimmunoassay and serum chromogranin A levels by enzyme-linked immunosorbent assay in pancreatic neuroendocrine tumor (n = 91) and other pancreatic conditions, and in healthy people (n = 104), to assess the relationships with clinical features. Results: The diagnostic ability of chromogranin B was as good as chromogranin A. The area under the curve was 0.79 for chromogranin B (sensitivity/specificity: 72%/77%), and 0.78 for chromogranin A (sensitivity/specificity: 79%/64%). Chromogranin B was not affected by proton pump inhibitor use and age, which affected chromogranin A. The number of cases without liver metastases was larger in pancreatic neuroendocrine tumor patients with positive chromogranin B and negative chromogranin A. Though chromogranin A significantly elevated cases with proton pump inhibitor treatment and had positive correlation with age, chromogranin B did not have the tendencies. However, both chromogranin B and chromogranin A elevated in the case with renal impairment. In addition, the logistic regression analysis showed that chromogranin B was superior to chromogranin A in differentiation of pancreatic neuroendocrine tumor from other pancreatic diseases. Conclusions: Compared with chromogranin A, chromogranin B may be more useful during proton pump inhibitor treatment and can detect tumors without liver metastases. In addition,

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Elevated chromogranin A (CgA) serum levels in the patients with advanced pancreatic cancer

Cited by 32 publications

References 47 publications

Ga-68 DOTATATE positron emission tomography computed tomography findings in patients with neuroendocrine tumor suspicion

Ga-68 DOTATATE positron emission tomography computed tomography findings in patients with neuroendocrine tumor suspicion

Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame

Utility of chromogranin B compared with chromogranin A as a biomarker in Japanese patients with pancreatic neuroendocrine tumors

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