Pancreatic neuroendocrine tumors: A review of serum biomarkers, staging, and management

Ma, Zuyi; Gong, Yuanfeng; Zhuang, Hongkai; Zhou, Zixuan; Huang, Shanzhou; Zou, Yiping; Huang, Bowen; Sun, Zhonghai; Zhang, Chuanzhao; Tang, Yunqiang; Hou, Baohua

doi:10.3748/wjg.v26.i19.2305

Cited by 112 publications

(95 citation statements)

References 123 publications

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“…Хромогранин А имеет наибольшую диагностическую чувствительность при распространенных формах заболевания, сопровождающихся метастатическим поражением печени и других органов [2,4,6,11]. В то же время чувствительность данного маркера значительно ниже при биологически неактивных панкреатических НЭО [2,8,9], что обусловливает необходимость поиска более эффективного комплекса универсальных маркеров для повышения точности биохимической диагностики этого типа неоплазий.…”

Section: Discussionunclassified

“…В настоящее время выделяют 2 основные группы биохимических маркеров НЭО: универсальные, не связанные с определенной симптоматикой, и специфические, ассоциированные с тем или иным гиперфункциональным синдромом [1][2][3][4][5][6]. Среди универсальных биомаркеров наибольшее значение имеет хромогранин А (ХгА) -белок семейства гранинов, который в настоящее время считается основным маркером НЭО [7][8][9][10][11]. Несмотря на то, что ХгА играет большую роль в биохимической диагностике НЭО различных локализаций, он имеет такие ограничения, как недостаточная чувствительность при локализованных формах заболевания, включая НЭО поджелудочной железы, а также зависимость концентрации в сыворотке крови от наличия сопутствующих заболеваний и получаемых препаратов [2,4,5,12].…”

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Сравнительное Исследование Хромогранина А И Хромогранина В У Больных С Нейроэндокринными Опухолями Желудка И Поджелудочной Железы

et al. 2021

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Section: Discussionunclassified

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Сравнительное Исследование Хромогранина А И Хромогранина В У Больных С Нейроэндокринными Опухолями Желудка И Поджелудочной Железы

et al. 2021

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“…On the other hand, poorly differentiated NENs can be negative for CgA, but positive for synaptophysin and NSE. Thus, CgA is a general biomarker for well-differentiated NENs and NSE is a specific general biomarker for poorly differentiated NENs[ 68 , 69 ]. Although these biomarkers are insufficient for diagnosis, they are good for assessing the prognosis and therapeutic response.…”

Section: Diagnosis Of Gep-nensmentioning

confidence: 99%

“…It can be used for monitoring the response to therapy, to detect recurrence and for assessing the prognosis. But the test is not widely available, and it needs further validation[ 7 , 69 ].…”

Section: Diagnosis Of Gep-nensmentioning

confidence: 99%

Gastroenteropancreatic neuroendocrine neoplasms: A clinical snapshot

Fernandez¹,

Agarwal²,

Pottakkat³

et al. 2021

WJGS

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Our understanding about the epidemiological aspects, pathogenesis, molecular diagnosis, and targeted therapies of neuroendocrine neoplasms (NENs) have drastically advanced in the past decade. Gastroenteropancreatic (GEP) NENs originate from the enteroendocrine cells of the embryonic gut which share common endocrine and neural differentiation factors. Most NENs are well-differentiated, and slow growing. Specific neuroendocrine biomarkers that are used in the diagnosis of functional NENs include insulin, glucagon, vasoactive intestinal polypeptide, gastrin, somatostatin, adrenocorticotropin, growth hormone releasing hormone, parathyroid hormone-related peptide, serotonin, histamine, and 5-hydroxy indole acetic acid (5-HIAA). Biomarkers such as pancreatic polypeptide, human chorionic gonadotrophin subunits, neurotensin, ghrelin, and calcitonin are used in the diagnosis of non-functional NENs. 5-HIAA levels correlate with tumour burden, prognosis and development of carcinoid heart disease and mesenteric fibrosis, however several diseases, medications and edible products can falsely elevate the 5-HIAA levels. Organ-specific transcription factors are useful in the differential diagnosis of metastasis from an unknown primary of well-differentiated NENs. Emerging novel biomarkers include circulating tumour cells, circulating tumour DNA, circulating micro-RNAs, and neuroendocrine neoplasms test (NETest) (simultaneous measurement of 51 neuroendocrine-specific marker genes in the peripheral blood). NETest has high sensitivity (85%-98%) and specificity (93%-97%) for the detection of gastrointestinal NENs, and is useful for monitoring treatment response, recurrence, and prognosis. In terms of management, surgery, radiofrequency ablation, symptom control with medications, chemotherapy and molecular targeted therapies are all considered as options. Surgery is the mainstay of treatment, but depends on factors including age of the individual, location, stage, grade, functional status, and the heredity of the tumour (sporadic vs inherited). Medical management is helpful to alleviate the symptoms, manage inoperable lesions, suppress postoperative tumour growth, and manage recurrences. Several molecular-targeted therapies are considered second line to somatostatin analogues. This review is a clinical update on the pathophysiological aspects, diagnostic algorithm, and management of GEP NENs.

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“…Surgery has been considered as the mainstay treatment modality for pNENs, especially for localized disease and is commonly recommended for localized nonfunctional pNENs with tumor size >2 cm and functional pNENs, while active surveillance is recommended for nonfunctional pNENs with tumor size <2 cm according to the European Neuroendocrine Tumor Society and the North American Neuroendocrine Tumor Society guidelines [ 8 – 12 ]. Chemotherapy and targeted therapy could inhibit specific molecular pathways to impede pNENs progression; PRRT is a novel treatment modality that binds to pNENs with overexpressed somatostatin receptor and then emits localized radiation [ 6 , 13 ]; SSAs demonstrate antisecretory properties and antiproliferative potency, as a frontline treatment modality for advanced or metastatic pNENs; however, sequencing of treatment with chemotherapy, targeted therapy, and PRRT requires further investigation [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Second Primary Malignancies in Patients with Pancreatic Neuroendocrine Neoplasms: A Population-Based Study on Occurrence, Risk Factors, and Prognosis

Wang

2021

Journal of Oncology

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Background. This study aimed to evaluate the risk factors of developing second primary malignancies (SPMs) among patients with pancreatic neuroendocrine neoplasms (pNENs) and the prognosis of pNENs patients with SPMs (pSPMs) using data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods. Data from patients diagnosed with pNENs between 1988 and 2016 were extracted. A case-control study was conducted to investigate the risk factors of developing SPMs among patients with pNENs. Meanwhile, cox regression analysis was also conducted to obtain the independent prognostic factors in pSPMs. Results. Of 7,630 patients with pNENs, 326 developed SPMs. Patients with pNENs who had not undergone surgery and had been diagnosed in recent periods had a higher risk of developing SPMs. The following independent prognostic predictors for pSPMs were identified: age, latency period, SEER stage, radiotherapy, and surgery. Conclusions. These findings may improve the surveillance of risk factors for developing SPMs in patients with pNENs and the prognostic risk factors in pSPMs.

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Pancreatic neuroendocrine tumors: A review of serum biomarkers, staging, and management

Cited by 112 publications

References 123 publications

Сравнительное Исследование Хромогранина А И Хромогранина В У Больных С Нейроэндокринными Опухолями Желудка И Поджелудочной Железы

Сравнительное Исследование Хромогранина А И Хромогранина В У Больных С Нейроэндокринными Опухолями Желудка И Поджелудочной Железы

Gastroenteropancreatic neuroendocrine neoplasms: A clinical snapshot

Second Primary Malignancies in Patients with Pancreatic Neuroendocrine Neoplasms: A Population-Based Study on Occurrence, Risk Factors, and Prognosis

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