Chromogranin A as Serum Marker for Neuroendocrine Neoplasia: Comparison with Neuron-Specific Enolase and the α-Subunit of Glycoprotein Hormones
| Autor: | E. P. Krenning, Jan Lindemans, Roger Bouillon, C. H. H. Schoenmakers, S. W. J. Lamberts, Dirk Jan Kwekkeboom, W. W. de Herder, F. R. E. Nobels, Willy Coopmans |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty Lung Neoplasms Endocrinology Diabetes and Metabolism Carcinoid tumors Clinical Biochemistry Enolase Carcinoid Tumor Neuroendocrine tumors Biochemistry Diagnosis Differential Endocrinology Neoplasms Internal medicine Biomarkers Tumor Chromogranins medicine Carcinoma Humans Thyroid Neoplasms Carcinoma Small Cell Aged biology business.industry Biochemistry (medical) Chromogranin A Hydroxyindoleacetic Acid Middle Aged medicine.disease Neuroendocrine Tumors medicine.anatomical_structure Medullary carcinoma Glycoprotein Hormones alpha Subunit Carcinoma Medullary Gastrinoma Phosphopyruvate Hydratase biology.protein Immunohistochemistry Female Pancreas business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 82:2622-2628 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jcem.82.8.4145 |
| Popis: | Chromogranin A (CgA) is gaining acceptance as a serum marker of neuroendocrine tumors. Its specificity in differentiating between neuroendocrine and nonneuroendocrine tumors, its sensitivity to detect small tumors, and its clinical value, compared with other neuroendocrine markers, have not clearly been defined, however. The objectives of this study were to evaluate the clinical usefulness of CgA as neuroendocrine serum marker. Serum levels of CgA, neuron-specific enolase (NSE), and the alpha-subunit of glycoprotein hormones (alpha-SU) were determined in 211 patients with neuroendocrine tumors and 180 control subjects with nonendocrine tumors. The concentrations of CgA, NSE, and alpha-SU were elevated in 50%, 43%, and 24% of patients with neuroendocrine tumors, respectively. Serum CgA was most frequently increased in subjects with gastrinomas (100%), pheochromocytomas (89%), carcinoid tumors (80%), nonfunctioning tumors of the endocrine pancreas (69%), and medullary thyroid carcinomas (50%). The highest levels were observed in subjects with carcinoid tumors. NSE was most frequently elevated in patients with small cell lung carcinoma (74%), and alpha-SU was most frequently elevated in patients with carcinoid tumors (39%). Most subjects with elevated alpha-SU levels also had elevated CgA concentrations. A significant positive relationship was demonstrated between the tumor load and serum CgA levels (P < 0.01, by chi 2 test). Elevated concentrations of CgA, NSE, and alpha-SU were present in, respectively, 7%, 35%, and 15% of control subjects. Markedly elevated serum levels of CgA, exceeding 300 micrograms/L, were observed in only 2% of control patients (n = 3) compared to 40% of patients with neuroendocrine tumors (n = 76). We conclude that CgA is the best general neuroendocrine serum marker available. It has the highest specificity for the detection of neuroendocrine tumors compared to the other neuroendocrine markers, NSE and alpha-SU. Elevated levels are strongly correlated with tumor volume; therefore, small tumors may go undetected. Although its specificity cannot compete with that of the specific hormonal secretion products of most neuroendocrine tumors, it can have useful clinical applications in subjects with neuroendocrine tumors for whom either no marker is available or the marker is inconvenient for routine clinical use. |
| Databáze: | OpenAIRE |
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