Is the combination of chromogranin A and pancreatic polypeptide serum determinations of interest in the diagnosis and follow-up of gastro-entero-pancreatic neuroendocrine tumours?

Walter, Thomas; Chardon, Laurence; Chopin-Laly, Xavier; Raverot, Véronique; Caffin, Anne-Gaëlle; Chayvialle, Jean‐Alain; Scoazec, Jean‐Yves; Lombard‐Bohas, Catherine

doi:10.1016/j.ejca.2011.11.005

Cited by 68 publications

(54 citation statements)

References 34 publications

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“…In their study, the diagnostic accuracy of these tumor markers was low compared to imaging (de Laat et al 2013). These results were supported by several other studies (Granberg et al 1999, Walter et al 2012, Rehfeld et al 2014. In the authors' opinion, the tumor markers PP, chromogranin A and glucagon can be omitted from MEN1 screening.…”

Section: Tumor Markerssupporting

confidence: 75%

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

Manoharan¹,

Albers²,

Bartsch³

2017

Endocrine-Related Cancer

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Prospective randomized data are lacking, but current clinical expert guidelines recommend annual screening examinations, including laboratory assessments and various imaging modalities (e.g. CT, MRI, scintigraphy and EUS) for patients with multiple endocrine neoplasia type 1 (MEN1). Routine screening is proposed to detect and localize neuroendocrine manifestations as early as possible. The goal is timely intervention to improve quality of life and to increase life expectancy by preventing the development of life-threatening hormonal syndromes and/or metastatic disease. In recent years, some studies compared different and new imaging methods regarding their sensitivity and utility in MEN1 patients. This present article reviews the proposed diagnostic tools for MEN1 screening as well as potential future perspectives.

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Section: Tumor Markerssupporting

confidence: 75%

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

Manoharan¹,

Albers²,

Bartsch³

2017

Endocrine-Related Cancer

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“…Both research groups found high concordance between CgA changes and tumor slope, demonstrating that marker elevation higher than 25% was a highly sensitive predictor (83 and 89%, respectively) of tumor progression. In contrast to these findings, a more recent retrospective study by Walter et al (2012) found that marker changes were consistent with morphology in only 51% of the cases and that a significant CgA elevation, defined as an at least 50% increase, was detectable in only 56% of the patients with progressive disease. More definite evidence about this issue has emerged in the last 2 years, with 2 prospective reports demonstrating the poor capability of CgA changes in reflecting morphological behavior of NENs.…”

Section: Assessment Of Morphological Evolution In Patients With Non-cmentioning

confidence: 59%

Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame

Marotta

Zatelli

Sciammarella³

et al. 2018

Endocrine-Related Cancer

128

104

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Owing to the heterogeneity of neuroendocrine neoplasms (NENs), the availability of reliable circulating markers is critical for improving diagnostics, prognostic stratification, follow-up and definition of treatment strategy. This review is focused on chromogranin A (CgA), a hydrophilic glycoprotein present in large dense core vesicles of neuroendocrine cells. Despite being long identified as the most useful NEN-related circulating marker, clinical application of CgA is controversial. CgA assays still lack standardization, thus hampering not only clinical management but also the comparison between different analyses. In the diagnostic setting, clinical utility of CgA is limited as hampered by (a) the variety of oncological and non-oncological conditions affecting marker levels, which impairs specificity; (b) the fact that 30-50% of NENs show normal CgA, which impairs sensitivity. Regarding the prognostic phase, there is prospective evidence which demonstrates that advanced NENs secreting CgA have poorer outcome, as compared with those showing non-elevated marker levels. Although the identification of cut-offs allowing a proper risk stratification of CgA-secreting patients has not been performed, this represents the most important clinical application of the marker. By contrast, based on prospective studies, the trend of elevated circulating CgA does not represent a valid indicator of morphological evolution and has therefore no utility for the follow-up phase. Ultimately, current knowledge about the role of the marker for the definition of treatment strategy is poor and is limited by the small number of available studies, their prevalent retrospective nature and the absence of control groups of untreated subjects.

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“…However, in a study conducted by Sherman et al, no correlation between CgA and survival was found in patients with PNETs in a multivariate analysis (24). Pancreatic polypeptide is a 36 amino acid protein secreted by endocrine cells located primarily in the pancreatic head and uncinate process, with a low sensitivity of 31% in PNETs (25). Neuron-specific enolase is a biomarker with a sensitivity of 33% and a specificity of 100% in patients with gastroenteropancreatic neuroendocrine tumors (26).…”

Section: Univariate Analysis Multivariate Analysis ------------------mentioning

confidence: 99%

Neutrophil-lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors

Luo

Liu

et al. 2017

Oncology Letters

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Abstract.Although the prognostic role of neutrophil-lymphocyte ratio (NLR) has been confirmed in a variety of tumors, the prognostic role of NLR in pancreatic neuroendocrine tumors (PNETs) has not been examined. The present study was performed to assess the role of NLR as a prognostic factor in patients with PNETs. Clinical data were retrospectively retrieved from a single institution. The best cut-off value for baseline NLR levels was determined by the receiver operating characteristic (ROC) curve and area under the ROC curve. The primary event was overall survival and event times were assessed by the Kaplan-Meier method. Potential factors associated with the elevation of NLR in PNETs were examined. A total of 165 consecutive patients with pathologically confirmed PNETs were included in this study. The cutoff value of NLR was 2.4 by ROC curve (area under ROC curve, 0.70). NLR >2.4 was found to be a poor prognostic factor in the univariate and multivariate analyses. Patients with a NLR value >2.4 had a higher proportion of tumor size at >3 cm (P= 0.001), TNM stage III or IV (P= 0.019), and G2/G3 (P= 0.003). We concluded that NLR is an independent predictor of overall survival for patients with PNETs. Aberrant elevation of NLR identifies high-risk patients with aggressive characteristics.

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Is the combination of chromogranin A and pancreatic polypeptide serum determinations of interest in the diagnosis and follow-up of gastro-entero-pancreatic neuroendocrine tumours?

Cited by 68 publications

References 34 publications

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

The future: diagnostic and imaging advances in MEN1 therapeutic approaches and management strategies

Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame

Neutrophil-lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors

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