Premium
Utility of chromogranin A, pancreatic polypeptide, glucagon and gastrin in the diagnosis and follow‐up of pancreatic neuroendocrine tumours in multiple endocrine neoplasia type 1 patients
Author(s) -
Qiu Wei,
Christakis Ioannis,
Silva Angelica,
Bassett Roland L.,
Cao Liyun,
Meng Qing H.,
Gardner Grubbs Elizabeth,
Zhao Hua,
Yao James C.,
Lee Jeffrey E.,
Perrier Nancy D.
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13119
Subject(s) - medicine , chromogranin a , multiple endocrine neoplasia , neuroendocrine tumors , gastrin , gastroenterology , glucagon , pancreatic polypeptide , lymphovascular invasion , endocrinology , metastasis , oncology , cancer , hormone , biology , immunohistochemistry , biochemistry , secretion , gene
Summary Objective Pancreatic neuroendocrine tumours ( PNET s) are the major source of disease‐specific mortality in multiple endocrine neoplasia type 1 ( MEN 1) patients. Chromogranin A (CgA), pancreatic polypeptide ( PP ), glucagon and gastrin have some diagnostic value in sporadic PNET s, but there is very little evidence for their efficacy in diagnosing PNET s in MEN 1 patients. Design We performed a retrospective chart review of the existing MEN 1 database in our institution. Patients One hundred and thirteen patients were eligible for diagnostic value analysis of tumour markers. Patients were excluded if measurement of tumour markers was missing, either 3 months prior to PNET diagnosis ( PNET patients) or prior to abdominal imaging (non‐ PNET patients). Measurements Clinicopathologic characteristics and of tumour marker measurements were analysed. Results Of 293 confirmed MEN 1 cases, 55 PNET s and 58 non‐ PNET s met inclusion criteria. The area under the curve ( AUC ) for CgA, PP , glucagon and gastrin in MEN 1 cases was 59·5%, 64·1%, 77·0% and 75·9%, respectively. The AUC for the combination of CgA, PP and gastrin was 59·6%. PP , but not CgA, glucagon or gastrin was significantly associated with both age and PNET functional status ( P = 0·0485 and 0·0188, respectively). No markers were significantly associated with sex, PNET size, tumour number, tumour location, American Joint Committee on Cancer (AJCC) stage, presence of lymph node metastasis, lymphovascular invasion or overall survival. CgA values were not significantly lower following PNET resection than pre‐operatively ( P = 0·554). Conclusions The value of blood markers for diagnosing PNET s in MEN 1 patients is relatively low, even when used in combination.