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Interest of Chromogranin A for diagnosis and follow‐up of endocrine tumours
Author(s) -
Nehar D.,
LombardBohas C.,
Olivieri S.,
Claustrat B.,
Chayvialle JA.,
Penes MC.,
Sassolas G.,
BorsonChazot F.
Publication year - 2004
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/j.1365-2265.2004.02030.x
Subject(s) - chromogranin a , concordance , medicine , carcinoid tumour , endocrine system , multiple endocrine neoplasia , endocrinology , predictive value , immunoradiometric assay , gastroenterology , neuroendocrine tumors , radioimmunoassay , immunohistochemistry , biology , hormone , biochemistry , gene
Summary objective To determine the interest of Chromogranin A (CgA) determination for diagnosis and follow‐up in patients with gastroenteropancreatic endocrine tumours (GEP‐ET) and multiple endocrine neoplasia type 1 (MEN‐1). patients and methods CgA levels were measured with an immunoradiometric assay in 124 sporadic GEP‐ET, 34 MEN‐1 and 127 controls. Serial determinations were performed in 56 patients (212 visits). Changes in CgA levels over 25% were considered as significant. results Using a cut‐off value of 130 µg/l, established from a receiver‐operating characteristic curve, the specificity of CgA was 98·4%, with a sensitivity of 62·9%, higher in secreting than in nonsecreting tumours (73% vs. 45%; P < 0·003) and related to the extent of metastatic spreading ( P < 0·001). In nonsecreting tumours, the positive predictive value (PPV) of CgA for the presence of metastases was 100% but the negative predictive value (NPV) was only 50%. In MEN‐1, high CgA levels indicated a pancreatic tumour with a 100% specificity but the sensitivity was 59%. During the follow‐up, the concordance between CgA and tumour evolution was 80%, whatever the secretory status. In patients with carcinoid tumours, the concordance was higher for CgA than for serotonin (81% vs. 54%; P < 0·001). conclusion Due to its high specificity, CgA determination may help to discriminate the endocrine character of a GEP tumour and to indicate a pancreatic tumour in MEN‐1. However, its low NPV in nonsecreting tumours limits its interest for diagnosis and staging. By contrast, serial evaluation of CgA seems of particular interest for the follow‐up of GEP‐ET tumours.