Plasma Chromogranin A as Marker for Survival in Patients With Metastatic Endocrine Gastroenteropancreatic Tumors

Arnold, R.; Wilke, A; Rinke, Anja; Mayer, Christina; Kann, Peter Herbert; Klose, Klaus–Jochen; Scherag, André; Hahmann, Maik; Müller, Hans‐Helge; Barth, Peter

doi:10.1016/j.cgh.2008.02.052

Cited by 170 publications

(136 citation statements)

References 23 publications

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“…Although plasma CgA levels are sensitive (70-85%) markers of GEP-NENs, they are nonspecific and elevated in other types of NENs as well as pancreatic, small-cell lung, and even some prostate carcinomas (Lawrence et al 2011b). In addition to its diagnostic value, plasma CgA levels have some correlation with tumor burden and may, in some circumstances, be used to monitor treatment of NENs (Arnold et al 2008b). CgA reduction of O80% following surgery of neuroendocrine hepatic metastases is predictive of subsequent symptom relief and disease control and associated with improved outcome.…”

Section: Circulating and Tissue Expression Of Cgamentioning

confidence: 99%

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

149

106

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) represent a heterogenous group of tumors arising from a variety of neuroendocrine cell types. The incidence and prevalence of GEPNENs have markedly increased over the last three decades. Symptoms are often absent in early disease, or vague and nonspecific even in advanced disease. Delayed diagnosis is thus common. Chromogranin A is the most commonly used biomarker but has limitations as does the proliferative marker Ki-67%, which is often used for tumor grading and determination of therapy. The development of a multidimensional prognostic nomogram may be valuable in predicting tumor behavior and guiding therapy but requires validation. Identification of NENs that express somatostatin receptors (SSTR) allows for SSTR scintigraphy and positron emission tomography imaging using novel radiolabeled compounds. Complete surgical resection of limited disease or endoscopic ablation of small lesions localized in stomach or rectum can provide cure; however, the majority of GEP-NENs are metastatic (most frequently the liver and/or mesenteric lymph nodes) at diagnosis. Selected patients with metastatic disease may benefit from advanced surgical techniques including hepatic resection or liver transplantation. Somatostatin analogs are effective for symptomatic treatment and exhibit some degree of antiproliferative activity in small intestinal NENs. There is a place for streptozotocin, temozolomide, and capecitabine in the management of pancreatic NENs, while new agents targeting either mTOR (everolimus) or angiogenic (sunitinib) pathways have shown efficacy in these lesions.

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Section: Circulating and Tissue Expression Of Cgamentioning

confidence: 99%

Neuroendocrine tumor disease: an evolving landscape

Frilling

Åkerström

Falconi

et al. 2012

Endocrine-Related Cancer

149

106

View full text Add to dashboard Cite

show abstract

“…The sensitivity of the CgA results is around 60-80% and is dependent of primary site, grade and status of the disease (29). Moreover, significantly higher median CgA levels are found in NET patients with liver metastases (30), the highest levels in patients with functioning ileal NET and carcinoid syndrome (27). Lymph node metastases do not seem to cause a significant increase in CgA levels (27,30).…”

Section: Generalmentioning

confidence: 83%

“…Moreover, significantly higher median CgA levels are found in NET patients with liver metastases (30), the highest levels in patients with functioning ileal NET and carcinoid syndrome (27). Lymph node metastases do not seem to cause a significant increase in CgA levels (27,30). CgA can be elevated in several other diseases, such as renal failure, cardiac disease and tumours other than NET, but the main cause of falsely elevated CgA is the use of proton pump inhibitors (PPIs) (12).…”

Section: Generalmentioning

confidence: 99%

“…The CgA molecule can exist in different molecular forms, depending on the type of NE cells and its concerning tumour (24). Therefore, the CgA result, measured in serum or plasma, is dependent of the (25), tend to correlate with tumour burden as well as recurrence and are considered a marker of bad prognosis in both ileal and pancreatic NET (26,27,28). The sensitivity of the CgA results is around 60-80% and is dependent of primary site, grade and status of the disease (29).…”

Section: Generalmentioning

confidence: 99%

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GEP-NETs UPDATE: Secreting gastro-enteropancreatic neuroendocrine tumours and biomarkers

Verbeek¹,

Korse²,

Tesselaar

2016

European Journal of Endocrinology

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Neuroendocrine tumours (NETs) are rare tumours with an annual incidence in the population in a range of 2-5 new cases per 100 000 inhabitants. NETs are widely variable in terms of anatomical location, hormone production, clinical behaviour and syndromes they can cause. This article reviews the many localizations and clinical presentations of NETs with a main focus on clinical biomarkers and their use in medical practice.

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“…89,95,103 However, high circulating CgA concentrations have been measured in gastrinoma patients despite the small primary tumour size and absence of metastases, possibly due to CgA secretion from G cells. 89,116 Whilst one study observed no correlation with extra-hepatic tumour burden, 117 another study showed high circulating CgA concentrations in patients with diffuse disease compared to local or hepatic disease. 118 Circulating CgB concentrations have been shown to correlate with phaeochromocytoma tumour burden.…”

Section: Tumour Burden Prognostic Indication and Monitoringmentioning

confidence: 99%

The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia

et al. 2013

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Neuroendocrine neoplasia (NEN) is a heterogeneous group of tumours and often represents a therapeutic challenge to clinicians. The peptides chromogranin A (CgA), chromogranin B (CgB) and cocaine-and amphetamine-regulated transcript (CART) are widely distributed throughout the neuroendocrine system. CgA and CgB have been used as general NEN biomarkers for many years, while CART has only recently been identified. Of these biomarkers, CgA is the most commonly used. However, circulating CgA concentrations exhibit considerable intra-individual biological variation, are altered by proton pump inhibitors (PPIs) and somatostatin analogues and are elevated in non-NEN malignancies. Therefore, interpretation of CgA results must be in the context of these confounding factors. The effects of treatment and non-NEN conditions on circulating CgB and CART concentrations are less well understood. CgB is less affected by impaired renal function and PPIs than CgA; while, circulating CART concentrations lack a diurnal variation in humans and are more reliable markers of pancreatic NEN malignancy than CgA. The utility of circulating CgA measurements in NEN prognosis, surveillance and disease recurrence has been widely investigated. However, the utility of CgB and CART in NEN management is yet to be elucidated. Further studies are needed to establish whether CgB and CART are useful alternatives to CgA.

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Plasma Chromogranin A as Marker for Survival in Patients With Metastatic Endocrine Gastroenteropancreatic Tumors

Cited by 170 publications

References 23 publications

Neuroendocrine tumor disease: an evolving landscape

Neuroendocrine tumor disease: an evolving landscape

GEP-NETs UPDATE: Secreting gastro-enteropancreatic neuroendocrine tumours and biomarkers

The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia

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