Significance of plasma chromogranin A determination in neuroendocrine tumour (NET) diagnosis.

Donica, Helena; Malecha-Jędraszek, Arleta; Strosławska, E; Burska, Agata; Szubstarski, Franciszek

doi:10.2478/v10042-010-0088-x

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…However, this kind of retrospective study can still be helpful in the diagnosis and treatment of future patients with PHNECs. Additionally, we do not have results for plasma chromogranin A, which is used to diagnose and monitor neuroendocrine tumors during treatment 39–41 . Previously, researchers determined the diagnostic sensitivity and specificity of chromogranin A in neuroendocrine tumors at 71% and 87%, respectively 41 .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, we do not have results for plasma chromogranin A, which is used to diagnose and monitor neuroendocrine tumors during treatment. [39][40][41] Previously, researchers determined the diagnostic sensitivity and specificity of chromogranin A in neuroendocrine tumors at 71% and 87%, respectively. 41 Finally, our study is limited by inconsistencies in treatment modality.…”

Section: Discussionmentioning

confidence: 99%

“…[39][40][41] Previously, researchers determined the diagnostic sensitivity and specificity of chromogranin A in neuroendocrine tumors at 71% and 87%, respectively. 41 Finally, our study is limited by inconsistencies in treatment modality. Surgical resection was considered a priority in the curative treatment of PHNEC, but there are no standard guidelines for palliative treatment.…”

Section: Discussionmentioning

confidence: 99%

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Clinical features and outcomes of primary hepatic neuroendocrine carcinomas

Park

Chung

Jang

et al. 2012

J of Gastro and Hepatol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical features and outcomes of primary hepatic neuroendocrine carcinomas

Park

Chung

Jang

et al. 2012

J of Gastro and Hepatol

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“…The most critical discrepancies were (a) the composition of the case groups, with the strongest difference being represented by the fact that some studies included NEN from all sites (Bernini et al 2001, Donica et al 2010, Molina et al 2011, Korse et al 2012, Marotta et al 2012, Tohmola et al 2014, whereas some others tried to analyze more homogeneous set of patients, mainly selecting gastroenteropancreatic tumors (Tomassetti et al 2001a, Peracchi et al 2003, Nehar et al 2004, Zatelli et al 2007, Belli et al 2009, Modlin et al 2013 (Table 1); (b) the composition of the control groups: although the majority of studies used healthy subjects as controls (Bernini et al 2001, Tomassetti et al 2001b, Peracchi et al 2003, Nehar et al 2004, Campana et al 2007, Zatelli et al 2007, Belli et al 2009, Donica et al 2010, Molina et al 2011, Korse et al 2012, which represents the best approach to assess the diagnostic performance of a marker (Shapiro 1999), some researchers determined the metrics of circulating CgA by comparing NEN with non-NEN tumors (Nobels et al 1998, Panzuto et al 2004 or active versus diseasefree NEN (Bajetta et al 1999, Panzuto et al 2004; (c) the consideration of interfering factors: some authors tried to clean up the control group from those conditions with known effect on CgA levels, thus obtaining a more pristine evaluation of marker specificity (Bernini et al 2001, Tomassetti et al 2001b, Nehar et al 2004, Campana et al 2007…”

Section: Circulating Cga In the Diagnostic Phase Of Nenmentioning

confidence: 99%

“…Indeed, authors applying the former approach reported values ranging from 95 to 100% (Bernini et al 2001, Tomassetti et al 2001b, Nehar et al 2004, Campana et al 2007, Belli et al 2009, Molina et al 2011, with the only exception of Zatelli et al (2007), who found 84/85% specificity (based on the detection method) likely due to the fact that CAG was not ruled out. By contrast, specificity was less than 90% in the majority of studies where exclusion of interfering conditions was not performed (Peracchi et al 2003, Donica et al 2010, Vezzosi et al 2011, Marotta et al 2012, Tohmola et al 2014. Furthermore, some authors specifically assessed the effect of benign conditions on test specificity by comparing the same cohort of NENs with separate groups of healthy subjects and patients carrying one or more interfering diseases ( …”

Section: Non-oncological Causes Of Cga Elevationmentioning

confidence: 99%

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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Diagnostic Value of Circulating Chromogranin A for Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Yang

et al. 2015

PLoS ONE

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BackgroundIn previous decades, chromogranin A (CgA) has been demonstrated to be the most promising biomarker for the diagnosis of neuroendocrine tumors (NETs), but its diagnostic value is still controversial. This meta-analysis aimed to estimate the potential diagnostic value of circulating CgA for NETs.MethodsWe collected relevant studies from several electronic databases as well as from reference lists. Diagnostic indices of CgA were pooled with random effects models. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) curves for the diagnosis of NETs were used to estimate the overall diagnostic efficiency.ResultsThrough a search strategy, 13 studies met the inclusion criteria and were included. These studies contained 1260 patients with NETs and 967 healthy controls in the total sample. As a result, the overall sensitivity, specificity and diagnostic odds ratio (DOR) were 0.73 (95% CI: 0.71 to 0.76), 0.95 (95% CI: 0.93 to 0.96) and 56.29 (95% CI: 25.27 to 125.38), respectively, while the summary positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 14.56 (95% CI: 6.62 to 32.02) and 0.26 (95% CI: 0.18 to 0.38), respectively. In addition, the area under the curve (AUC) of the circulating CgA in the diagnosis of NETs was 0.8962.ConclusionsThese data demonstrate that circulating CgA is an efficient biomarker for the diagnosis of NETs with high sensitivity and specificity, which indicates that it may be helpful for the clinical management of NETs. However, further studies are needed to clarify this issue.

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Significance of plasma chromogranin A determination in neuroendocrine tumour (NET) diagnosis.

Cited by 5 publications

References 32 publications

Clinical features and outcomes of primary hepatic neuroendocrine carcinomas

Clinical features and outcomes of primary hepatic neuroendocrine carcinomas

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

Diagnostic Value of Circulating Chromogranin A for Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

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