Original article—liver, pancreas, and biliary tractPlasma Chromogranin A as Marker for Survival in Patients With Metastatic Endocrine Gastroenteropancreatic Tumors
Section snippets
Patients
In 1988 a tumor register was initiated with data on clinical presentation and treatment, histopathology, and laboratory values of 641 patients with GEP tumors admitted in our institution. CgA levels reported in this study were used only if estimated in our laboratories by using an enzyme-linked immunosorbent assay that has not changed since January 1, 1995. Three hundred forty-four patients fulfilled this criterion and were used for the first part of the study investigating plasma CgA levels as
Characteristics of Enrollees
Table 1, Table 2 provide descriptive information on patient characteristics of both parts of the study. For 6 patients the primary was unknown (Table 2). However, the exclusion of a pancreatic or bronchial origin according to CT, MRI, and Octreoscan suggested that these tumors originated from the midgut. Both subsamples listed in Table 1, Table 2 consisted primarily of midgut and nonfunctioning pancreatic tumors.
Plasma Chromogranin A as a Prognostic Marker for Survival
As shown in Table 1, Table 3, elevated plasma CgA levels were associated with
Discussion
This study demonstrated in accordance with previous reports that plasma CgA is a valuable marker for malignant GEP tumors of different origins, with the highest CgA plasma levels in patients with carcinoid syndrome.8, 10, 15, 16, 17, 18, 19, 20 As shown in the first part of this study, survival was reduced if plasma CgA levels were >200 U/L at the time of diagnosis. The cutoff value was chosen as the rounded value of 210 U/L, the median of plasma CgA for the whole group of patients. It is
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2021, Surgery (United States)Citation Excerpt :Serum CgA levels accurately reflect the clinical status of patients with advanced disease, and they have demonstrated utility in both tumor surveillance and assessment of treatment response.10 An elevated serum CgA is frequently used as both a diagnostic and prognostic adjunct for NETs, given its correlation with metastatic disease burden and association with disease-specific-survival in several NET types; however, its significance in locoregional disease remains poorly defined.11–15 Elevated preoperative serum CgA levels in localized pancreatic NETs has been used to identify patients with tumors who may benefit from resection, though a similar prognostic role for preoperative CgA levels in SB-NET has yet to be established.13
Small Bowel Neuroendocrine Tumors
2020, Current Problems in Surgery
Supported by grants from Novartis, Nürnberg, Germany.