Chromogranin A as Serum Marker for Neuroendocrine Neoplasia: Comparison with Neuron-Specific Enolase and the  -Subunit of Glycoprotein Hormones

Nobels, Frank

doi:10.1210/jc.82.8.2622

Cited by 199 publications

(233 citation statements)

References 19 publications

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“…CgA and NSE had a 59% and 38% sensitivity respectively. Our results for both markers are in a lower range than that of other reported series (Cunningham et al, 1992;Nobels et al, 1997). This may be related to the size of the patient population studied and also to its characteristics: a high percentage of patients had extensive disease (80%), a high percentage had previously been teated (89%), a relatively high proportion had no known secretions (30%) and patients with small-cell lung carcinoma or neuroblastoma, in whom NSE is known to be a sensitive marker, were excluded from the study.…”

Section: Discussioncontrasting

confidence: 82%

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Neuron-specific enolase and chromogranin A as markers of neuroendocrine tumours

Baudin

Gigliotti²,

Ducreux³

et al. 1998

Br J Cancer

220

138

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Summary Circulating neuron-specific enolase (NSE) and chromogranin A (CgA) were measured in 128 patients with neuroendocrine tumours (NET) to compare their sensitivity and specificity, to investigate factors associated with elevated serum levels and to determine the usefulness of these markers in the follow-up of NET patients. NSE (Cispack NSE, Cis Bio Intemational, Gif-sur-Yvette, France; normal <12.5 gig h1), and chromogranin A (CgA-Riact, Cis Bio Intemational, normal <100 jig 1-') were measured in 128 patients without renal insufficiency.There were 99 patients with gastroenteropancreatic (GEP) NET, 19 with medullary thyroid carcinoma and ten with phaeochromocytoma. Fiftythree patients with non-NET were studied as controls. Serum NSE and CgA levels were elevated in 48 (38%) and 76 (59%) of the 128 NET patients respectively. In all groups of NET patients, CgA proved to be more sensitive than NSE. NSE and CgA had a specificity of 73°o and 68% respectively. Immunostaining for NSE was positive in three out of eight controls with elevated CgA levels, whereas immunostaining for CgA and synaptophysin was negative in all cases. Elevated CgA levels were significantly associated with two independent parameters, namely the presence of other secretions (P= 0.0001) and a heavy tumour burden (P= 0.001). Elevated NSE levels were exclusively associated with poor tumour differentiation (P= 0.01). Among six patients with NET followed for 11-37 months. CgA appeared to be a better marker of tumour evolution than NSE. We suggest that CgA ought to be the only general marker screened in NET patients.

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Section: Discussioncontrasting

confidence: 82%

“…NSE has already been reported to have a low specificity (Vinores et al, 1984;Schmechel, 1985;Kaiser et al, 1989;Body et al, 1992;Nobels et al, 1997). Like other authors in initial studies Bemsteir 1984: Eriksson et al 1989), we chose the upper threshold of the normal range of CgA to attain a high level of specificity.…”

Section: Discussionmentioning

confidence: 97%

Neuron-specific enolase and chromogranin A as markers of neuroendocrine tumours

Baudin

Gigliotti²,

Ducreux³

et al. 1998

Br J Cancer

220

138

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“…Clinical impression of a linkage between highgrade aggressive tumours and a rise in serum AFP and hCGb levels led us to perform a systematic review of the utility of AFP and hCGb measurement in our NET patients. Although, very little is known about AFP in NETs, some useful data already exist on the expression and value of a-and b-subunits of hCG (Heitz et al, 1987;Eriksson et al, 1989;Grossmann et al, 1994;Nobels et al, 1997). These subunits have been shown to be raised in a significant proportion of NET patients and to have the ability to differentiate between benign and malignant gastroenteropancreatic tumours (Heitz et al, 1987;Eriksson et al, 1989;Grossmann et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

α-Fetoprotein and human chorionic gonadotrophin-β as prognostic markers in neuroendocrine tumour patients

et al. 2008

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Serum chromogranin A is the most useful general and prognostic tumour marker available for neuroendocrine tumour (NET) patients. The role of other tumour markers is less clear. In order to determine the diagnostic and prognostic value of serum afetoprotein (AFP) and human chorionic gonadotrophin-b (hCGb) in NETs, a database containing biochemical, histological, and survival data on 360 NET patients was constructed. This data was statistically assessed, using Statistical Package for the Social Sciences, to determine the utility of commonly measured tumour markers with particular emphasis on AFP and hCGb. a-Fetoprotein and hCGb were raised in 9.5 and 12.3% of patients respectively and jointly raised in 9.1% of patients in whom it was measured. aFetoprotein levels associated strongly and positively with tumour grade, serum CgA and hCGb levels, and worse survival. Human chorionic gonadotrophin-b levels also associated strongly and positively with serum CgA and AFP levels, and worsening survival. aFetoprotein and hCGb are elevated in high-grade NETs, with a rapidly progressive course and poorer survival. They also correlate with chromogranin-A, which is known to be a marker of tumour burden and to have prognostic value. Thus AFP and hCGb are clinically important in NETs and when elevated are poor prognostic markers.

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“…Although its specificity is lower than that of urinary 5-HIAA level (86% and 100%, respectively), its sensitivity is much higher (35% and 68%, respectively) [34] and reported to be the highest in the foregut and functioning tumors. Levels of CgA are correlated with tumor burden [37], and a direct comparison between serum CgA and urinary 5-HIAA levels showed a higher accuracy for CgA in the detection of relapse in carcinoid patients [38]. A significantly worse survival is described in patients with very high levels of CgA (>5,000 µg/l).…”

Section: Tumor Markersmentioning

confidence: 99%

Metastatic Carcinoid Tumors: A Clinical Review

2005

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Carcinoid tumors are neuroendocrine tumors derived from enterochromaffin cells, which are widely distributed in the body. They can originate from any location in the body, but they are traditionally described as originating from the foregut, midgut, and hindgut. Although the overall incidence of carcinoid tumors appears to have increased in the past decades, the prognosis for patients with metastatic carcinoid tumors has improved during the last decade. Due to longer survival times, complications, such as carcinoid heart disease, and new metastatic patterns, like skin and bone metastases, may become more important features of carcinoid disease. Therapy focused on these complications should be part of the management. Combining new diagnostic and treatment modalities in metastatic carcinoid patients may result in better quality of life and longer survival times. The increasing number of therapeutic options and diagnostic procedures requires a multidisciplinary approach, with decisions made in multidisciplinary meetings focused on "tailor-made" therapy based on patients' specific conditions. Because carcinoid tumors are uncommon, effort should be made to treat these patients in specialized centers and for these centers to join together in multicenter studies. The Oncologist 2005;10:123-131The Oncologist 2005;10:123-131 www.TheOncologist.com

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Chromogranin A as Serum Marker for Neuroendocrine Neoplasia: Comparison with Neuron-Specific Enolase and the -Subunit of Glycoprotein Hormones

Cited by 199 publications

References 19 publications

Neuron-specific enolase and chromogranin A as markers of neuroendocrine tumours

Neuron-specific enolase and chromogranin A as markers of neuroendocrine tumours

α-Fetoprotein and human chorionic gonadotrophin-β as prognostic markers in neuroendocrine tumour patients

Metastatic Carcinoid Tumors: A Clinical Review

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