The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia

Bech, PR; Martin, NM; Ramachandran, Radha; Bloom, S.R.

doi:10.1177/0004563213489670

Cited by 22 publications

(28 citation statements)

References 122 publications

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“…Therefore, "cutoff levels" recommended for decision-making should be applied with caution, and each institution has to define its own "cutoff levels." Chromogranin B Plasma chromogranin B (CgB) may be of value in the follow-up of BP and rectal NEN [18] . However, the availability for CgB is limited.…”

Section: Tumor Markersmentioning

confidence: 99%

“…Other PET tracers, such as 64 Cu-DOTATATE-PET-CT [30,31] , 18 In-DTPA-exendin-4 SPECT-CT [37] , may be used in follow-up if positive at baseline and if available at the center. Currently, there are only limited data available of PET-based imaging for routine follow-up, and its significance in this respect is currently not possible to define.…”

Section: Functional Imaging Somatostatin Receptor Scintigraphy (Srs) mentioning

confidence: 99%

“…Grade uptake at SRI as well as homogeneity of uptake should be specified [38] , also to evaluate the eligibility for peptide receptor radionuclide treatment. 18 FDG-PET-CT has a higher sensitivity than SRS in patients with G3 NEN and should instead be utilized for follow-up in this group of patients [39] . Furthermore, 18 FDG-PET-CT is frequently positive in G2 NEN with a high Ki-67 index and in aggressive and rapidly growing NEN [39,40] .…”

Section: Functional Imaging Somatostatin Receptor Scintigraphy (Srs) mentioning

confidence: 99%

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ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation

Knigge

Capdevila²,

Bartsch³

et al. 2017

Neuroendocrinology

107

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ENETS consensus recommendations for the standards of care in neuroendocrine neoplasms (NEN) concerning follow-up and documentation are considered in this review. The documentation of patients with NEN should include the most relevant data characterizing an individual patient from the first contact with his/her physician/hospital until his/her last presentation during follow-up. It is advocated that follow-up occurs in specialized NEN centers with regular NEN tumor boards with expert panels. The follow-up should be in accordance with the ENETS consensus guidelines from 2011 and 2016, the present and coming WHO classification and ENETS/UICC recommendations for TNM staging. The recommendations for follow-up in patients with thymic, bronchopulmonary and gastroenteropancreatic NEN are given in Table 1. However, it should be stressed that evidence-based studies for follow-up are largely missing.

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Section: Tumor Markersmentioning

confidence: 99%

Section: Functional Imaging Somatostatin Receptor Scintigraphy (Srs) mentioning

confidence: 99%

Section: Functional Imaging Somatostatin Receptor Scintigraphy (Srs) mentioning

confidence: 99%

See 1 more Smart Citation

ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation

Knigge

Capdevila²,

Bartsch³

et al. 2017

Neuroendocrinology

107

View full text Add to dashboard Cite

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“…In a comparative study of 44 patients, CgA was expressed in nearly 100%, CgB was present in 88% and CgC was only present in 6%. A commercial assay is available for circulating CgB which, unlike that used for CgA, is not affected by PPIs or impaired kidney function [62]. …”

Section: Current Net Biomarkers: Monoanalytesmentioning

confidence: 99%

Neuroendocrine Tumor Biomarkers: Current Status and Perspectives

et al. 2014

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The identification of accurate harbingers of disease status and therapeutic efficacy are critical requirements in precise diagnosis and effective management. Initially, tissue analysis was regarded as ideal but invasive strategies represent risk compared with peripheral blood sampling. Thus far, most biomarkers, whether in tissue or blood/urine, have been single analytes with varying degrees of sensitivity and specificity. Some analytes have not exhibited robust metrics or have lacked methodological rigor. Neuroendocrine disease represents an area of dire biomarker paucity since the individual biomarkers (gastrin, insulin, etc.) are not widely applicable to the diverse types of neuroendocrine neoplasia. Broad-spectrum markers such as chromogranin A have limitations in sensitivity, specificity and reproducibility. Monoanalytes cannot define the multiple variables (proliferation, metabolic activity, invasive potential, metastatic propensity) that constitute tumor growth. The restricted status of the neuroendocrine neoplasia field has resulted in a lack of comprehensive knowledge of the molecular and cellular biology of the disease, with tardy application of innovative technology. This overview examines limitations in current practice and describes contemporary viable strategies under evaluation, including the identification of novel analytes (gene transcripts, microRNA), circulating tumor cells and metabolic imaging agents that identify disease. Novel requirements are necessary to develop biomathematical algorithms for synchronous calibration of multiple molecular markers and predictive nomograms that interface biological variables to delineate disease progress or treatment efficacy. Optimally, the application of novel techniques and amalgamations of multianalyte assessment will provide a personalized molecular disease signature extrapolative of neuroendocrine neoplasia status and likelihood of progression and predictive of therapeutic opportunity.

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“…The determination of circulating chromogranin A (CgA), based on the secretory nature of GEP-NENs, has until now generally been considered the most useful biomarker. However, CgA is not highly specific to GEP-NENs, since it can be found in other malignancies and other non-tumor-related conditions such as chronic atrophic gastritis, proton pump inhibitor (PPI) therapy, renal insufficiency, systemic hypertension and severe liver failure [7,8]. …”

Section: Introductionmentioning

confidence: 99%

Chromogranin A in Diagnosing and Monitoring Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Large Series from a Single Institution

et al. 2014

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Background/Aims: Plasma chromogranin A (CgA) is the most widely used biochemical biomarker in the diagnostic workup and follow-up of gastroenteropancreatic neuroendo- crine neoplasms (GEP-NENs). Herein, we assessed the clinical utility of CgA in diagnosing and monitoring a large series of GEP-NENs. Patients and Methods: A total of 181 GEP-NEN patients (87 males, 94 females) with pancreatic (n = 81) and gastrointestinal neoplasms (n = 100) were included; 99 patients had grade (G)1 NENs (Ki-67 ≤2%), 57 G2 NENs (Ki-67 3-20%) and 25 G3 NENs (Ki-67 >20%); 81 patients had tumor-node-metastasis (TNM) stage I, 14 stage II, 17 stage III and 69 stage IV cancer. For every patient, CgA values were assessed at diagnosis and during follow-up. Results: At diagnosis, the CgA values were above the upper reference limit in 148 patients (82%); the median CgA levels were significantly higher in functioning than in nonfunctioning tumors (295 vs. 43 U/l; p = 0.0001) as well as significantly higher in patients with metastases than in those without metastases (324.5 vs. 42 U/l; p = 0.0001). In logistic regression analysis, baseline CgA levels were significantly associated with Ki-67 index (p < 0.0001) and TNM stage (p < 0.0001) independently of the age and sex of the patient and the primary site of the tumor. The overall 5- and 10-year survival rates were 74 and 64.5%, respectively. A low Ki-67 index, the type of treatment and an early CgA decrease after treatment were positively correlated with the survival rate. After radical surgery, 15/95 patients relapsed, and an increase in CgA values anticipated the clinical and objective disease recurrence after a period of 9-12 months. Conclusions: In GEP-NENs, plasma CgA has a significant prognostic relevance.

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The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia

Cited by 22 publications

References 122 publications

ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation

ENETS Consensus Recommendations for the Standards of Care in Neuroendocrine Neoplasms: Follow-Up and Documentation

Neuroendocrine Tumor Biomarkers: Current Status and Perspectives

Chromogranin A in Diagnosing and Monitoring Patients with Gastroenteropancreatic Neuroendocrine Neoplasms: A Large Series from a Single Institution

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