Characterization and plasma measurement of the WE-14 peptide in patients with pheochromocytoma

PLoS One. 2014 Feb 11;9(2):e88698. doi: 10.1371/journal.pone.0088698. eCollection 2014.

Abstract

Granins and their derived peptides are valuable circulating biological markers of neuroendocrine tumors. The aim of the present study was to investigate the tumoral chromogranin A (CgA)-derived peptide WE-14 and the potential advantage to combine plasma WE-14 detection with the EM66 assay and the existing current CgA assay for the diagnosis of pheochromocytoma. Compared to healthy volunteers, plasma WE-14 levels were 5.4-fold higher in patients with pheochromocytoma, but returned to normal values after surgical resection of the tumor. Determination of plasma CgA and EM66 concentrations in the same group of patients revealed that the test assays for these markers had an overall 84% diagnostic sensitivity, which is identical to that determined for WE-14. However, we found that WE-14 measurement improved the diagnostic sensitivity when combined with the results of CgA or EM66 assays. By combining the results of the three assays, the sensitivity for the diagnosis of pheochromocytoma was increased to 95%. In fact, the combination of WE-14 with either CgA or EM66 test assays achieved 100% sensitivity for the diagnosis of paragangliomas and sporadic or malignant pheochromocytomas if taken separately to account for the heterogeneity of the tumor. These data indicate that WE-14 is produced in pheochromocytoma and secreted into the general circulation, and that elevated plasma WE-14 levels are correlated with the occurrence of this chromaffin cell tumor. In addition, in association with other biological markers, such as CgA and/or EM66, WE-14 measurement systematically improves the diagnostic sensitivity for pheochromocytoma. These findings support the notion that granin-processing products may represent complementary tools for the diagnosis of neuroendocrine tumors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Gland Neoplasms / blood*
  • Adult
  • Aged
  • Biomarkers / blood
  • Chromaffin Cells / cytology
  • Chromogranin A / blood*
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Proteins / blood*
  • Neuroendocrine Tumors / blood*
  • Peptides / chemistry*
  • Pheochromocytoma / blood*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Biomarkers
  • Chromogranin A
  • Neoplasm Proteins
  • Peptides
  • chromogranin A-derived peptide, WE-14

Grants and funding

This work was supported by INSERM U982, Conseil Régional de Haute-Normandie, the Centre d’Investigation Clinique of Rouen hospital INSERM U204, Fondation pour la Recherche Médicale, Fédération des Maladies Orphelines, Ligue de Recherche Contre le Cancer de Haute-Normandie, Association pour la Recherche sur le Cancer, and the grant PHRC AOM 06179 from Institut National de la Santé et de la Recherche Médicale and Ministère Délégué à la Recherche et aux Nouvelles Technologies for the COMETE Network. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.