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Chromogranin A in patients with acid hypersecretion and/or hypergastrinaemia
Author(s) -
HIRSCHOWITZ B. I.,
WORTHINGTON J.,
MOHNEN J.,
HABER M.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03439.x
Subject(s) - gastrinoma , chromogranin a , gastrin , zollinger ellison syndrome , enterochromaffin like cell , medicine , enterochromaffin cell , achlorhydria , gastroenterology , gastric acid , pernicious anaemia , endocrinology , stomach , secretion , immunohistochemistry , serotonin , receptor
Summary Background Chromogranin has been proposed as a marker for gastrin‐dependent enterochromaffin‐like cell proliferation. Aim To examine this question in three populations: acid hypersecretors with gastrinoma (Zollinger–Ellison), or without gastrinoma (non‐Zollinger–Ellison), and also in pernicious anaemia with achlorhydria‐caused hypergastrinaemia. Methods We measured serum chromogranin, gastrin, gastric secretion and counted and quantified hyperplasia of enterochromaffin‐like cells in gastric biopsies from 38 Zollinger–Ellison and 13 non‐Zollinger–Ellison patients being treated with lansoprazole, for 5 years (median) and again 2.5 years later. We also studied 12 patients with pernicious anaemia, half with gastric enterochromaffin‐like cell carcinoids. Results Serum chromogranin was elevated in patients with gastrinoma, even without any enterochromaffin‐like cell proliferation, but not in non‐Zollinger–Ellison acid hypersecretors with normal gastrin ( P < 0.001). In the hypersecretors chromogranin correlated well with serum gastrin ( r = 0.82), but not with enterochromaffin‐like cell proliferation. Moreover, chromogranin was normal or near normal (<75 ng/mL) despite very high serum gastrin in five of six patients with pernicious anaemia and enterochromaffin‐like cell carcinoids. Conclusions Chromogranin is not a reliable marker for enterochromaffin‐like cell activity or proliferation up to and including carcinoid; chromogranin originates in the gastrinoma and, like gastrin, is a marker for gastrinoma in acid hypersecretors.