The importance of the measurement of circulating markers in patients with neuroendocrine tumours of the pancreas and gut.

Abstract

The measurement of general and specific biochemical markers in patients with neuroendocrine tumours assists with diagnosis and gives an indication of the effectiveness of treatment and they may be used as prognostic indicators. There is much agreement that chromogranin A is the most universally helpful marker; it is found to be elevated in the circulation of about 90% of patients with metastatic neuroendocrine tumours and there are several excellent commercially available kits which give reliable estimations. Specific markers are useful for diagnosis also, and are helpful indicators of the effectiveness of treatment, particularly where tumour bulk may not change as much as tumour activity. Sporadic pancreatic neuroendocrine tumours may secrete more than one peptide and this indicates a worsening prognosis. Because of the wide variation in the progression of neuroendocrine tumours, a prognostic indicator gives a significant advantage to the clinician in order to facilitate optimum treatment at the optimum stage of disease. Both chromogranin A and neurokinin A have been used as powerful prognostic indicators for midgut carcinoid tumours.

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

“…Often a rise in tumour marker levels may precede clinical indicators of disease progression such as worsening diarrhoea, facial flushing, and weight loss, as well as objective indicators of disease progression as determined radiologically. Furthermore, an increase in the number of expressed tumour markers is associated with worsening prognosis (Ardill and Erikkson, 2003).…”

Chromogranin A and Neuroendocrine Tumors

“…This information is useful for the initial diagnosis and during the followup for monitoring patients with non functional disease and under medical treatment. Several of the markers are good prognostic markers for both carcinoid and pancreatic disease (Ardill & Erikkson , 2003).…”

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

“…With regard to intestinal NETs, endocrine tumours of the jejunum and ileum produce serotonin, but because of the hepatic first-pass effect, this secretion only gives rise to carcinoid syndrome in patients who have developed liver metastases. Quantification of the urinary excretion of the principal metabolite of serotonin, 5-HIAA, is 73% sensitive and 100% specific for detecting the presence of advanced functional NET of the small intestine (42).…”