Perspectives on the diagnostic, predictive and prognostic markers of neuroendocrine neoplasms (Review)

Abstract

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumors with different types of physiology and prognosis. Therefore, prognostic information, including morphological differentiation, grade, tumor stage and primary location, are invaluable and contribute to the formulation of treatment decisions. Biomarkers that are currently used, including chromogranin A (CgA), serotonin and neuron-specific enolase, are singular parameters that cannot be used to accurately predict variables associated with tumor growth, including proliferation, metabolic rate and metastatic potential. In addition, site-specific biomarkers, such as insulin and gastrin, cannot be applied to all types of NENs. The clinical application of broad-spectrum markers, as it is the case for CgA, remains controversial despite being widely used. Due to limitations of the currently available mono-analyte biomarkers, recent studies were conducted to explore novel parameters for NEN diagnosis, prognosis, therapy stratification and evaluation of treatment response. Identification of prognostic factors for predicting NEN outcome is a critical requirement for the planning of adequate clinical management. Advances in 'liquid' biopsies and genomic analysis techniques, including microRNA, circulating tumor DNA or circulating tumor cells and sophisticated biomathematical analysis techniques, such as NETest or molecular image-based biomarkers, are currently under investigation as potentially novel tools for the management of NENs in the future. Despite these recent findings yielding promising observations, further research is necessary. The present review therefore summarizes the existing knowledge and recent advancements in the exploration of biochemical markers for NENs, with focus on gastroenteropancreatic-neuroendocrine tumors. Contents1. Introduction 2. Aim and search strategy 3. Currently available biomarkers 4. Potential novel biomarkers 5. Conclusions

Four decades of experience with carcinoid heart disease: An analysis of 84 patients

“…Then, patients at risk of CHD could be monitored more closely, whereas patients that are classified as low risk for developing CHD would have to visit the hospital less frequently, hence reducing both patient and hospital burden. A recent review by Ciobanu et al has summarized available biomarkers for neuroendocrine neoplasms and possible future biomarkers 43 . Unfortunately, there are currently no candidate biomarkers that show promising perspectives for the screening for CHD.…”

Metastatic Neuroendocrine Neoplasms of Unknown Primary: Clues from Pathology Workup

“…In modern medicine, auxiliary molecular testing is gaining ground as a complementary analysis to aid in therapeutic decision making, as mutational screening panels may identify actionable variants in NENs not responsive to conventional treatments [23,58]. However, there are also diagnostic benefits of utilizing next-generation sequencing (NGS) in clinical routine, as NENs developing in different tissues may have disparate genetic backgrounds and thereby be of help when assessing NEN-UPs [59].…”