Serum chromogranin-A in hepatocellular carcinoma: Diagnostic utility and limits
| Autor: | Graziella D’arrigo, Carmela Morace, Francesco Martino, Domenico Migliorato, Agata Zirilli, Oscar Ferraù, Freni Ma, Carmelo Luigiano, Anna Bene, Antonino Ajello, Santi Turiano, Aldo Spadaro |
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| Předmět: |
Adult
Liver Cirrhosis Male endocrine system medicine.medical_specialty Pathology Carcinoma Hepatocellular Cirrhosis Sensitivity and Specificity Gastroenterology Liver disease Internal medicine Chromogranins medicine Carcinoma Humans neoplasms Aged Hepatitis Chronic Aged 80 and over Hepatitis Kidney business.industry Liver Neoplasms General Medicine hepatocellular carcinoma medicine.disease digestive system diseases medicine.anatomical_structure chromogranin Hepatocellular carcinoma Heart failure Concomitant Chromogranin A Female Brief Reports business Biomarkers |
| Zdroj: | Scopus-Elsevier |
| Popis: | The utility of serum alpha-fetoprotein (alpha-FP) for the detection of hepatocellular carcinoma (HCC) is questionable. High serum levels of chromogranin-A (CgA) have recently been reported in HCC. Impaired hepatic, renal, and heart functions influence circulating CgA. The aim of this study was to assess sensitivity and specificity of serum CgA as a marker of HCC in patients with liver cirrhosis (LC).Serum CgA levels were measured by RIA in 339 patients of which 54 HCC, 132 LC, 45 chronic hepatitis (CH), 27 chronic heart failure (CHF), 36 chronic renal failure (CRF), 45 chronic inflammatory bowel disease (IBD) as disease controls and in 75 healthy controls. Patients with liver disease or IBD and concomitant renal and/or heart failure were excluded. Pearson correlation, non-parametric combination test and confidence interval analysis were used for statistical analysis.Serum CgA above normal values (100 ng/mL) were found in 83% of HCC patients, in 48% of LC patients, in 20% of CH patients, in 33% of IBD patients, in 92% of CRF patients, in 100% of CHF patients, and in none of the healthy controls. The mean CgA values in HCC (769+/-1 046), in LC (249+/-369), in CH (87+/-94), in CRF (1,390+/-1,401), in CHF (577+/-539), in IBD (146+/-287) were significantly higher than those in healthy controls (48+/-18). HCC patients had higher CgA values (P0.01) than LC, CH, and IBD patients but did not differ from those with CRF or CHF. The 95% CI for the mean (250-1 289 ng/mL) in HCC patients was selected as a CgA range and the lower value of such range was assumed as cut-off. Sensitivity and specificity of CgA, calculated in relation to the cut-off in patients with cirrhosis and HCC, were respectively 61% (CI 48-73%) and 82% (CI 75-88%). Serum alpha-FP values were200 ng/mL in 21% of the HCC patients and in none of the LC patients. No significant correlation was found between alpha-FP and CgA in patients with HCC and in patients with cirrhosis.When HCC is suspected and alpha-FP is normal or200 ng/mL, CgA serum values represent a complementary diagnostic tool, unless kidney or heart failure is present. |
| Databáze: | OpenAIRE |
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