Circulating Chromogranin A as A Marker for Monitoring Clinical Response in Advanced Gastroenteropancreatic Neuroendocrine Tumors

PLoS One. 2016 May 9;11(5):e0154679. doi: 10.1371/journal.pone.0154679. eCollection 2016.

Abstract

Chromogranin A (CgA), present in the chromaffin granules of neuroendocrine cells, is a useful biomarker for the diagnosis of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). This study was conducted to investigate the potential role of circulating CgA in monitoring clinical response in Chinese patients with advanced GEP-NETs. Eighty patients with advanced GEP-NETs treated in Peking University Cancer Hospital from September 2011 to May 2014 and 65 healthy individuals were included in this study. Serum CgA levels were analyzed for relationship with patient's baseline characteristics and clinical outcome. Median CgA levels were significantly higher in patients with advanced GEP-NETs than in healthy individuals (93.8 ng/mL vs. 37.1 ng/mL; P<0.01), as well as significantly higher in patients with carcinoid syndrome or liver metastasis than in those without carcinoid syndrome (298.8 ng/mL vs. 82.9 ng/mL; P = 0.011) or liver metastasis (137.0 ng/mL vs. 64.4 ng/mL; P = 0.023). A CgA cutoff value of 46.2 ng/mL was used in this study with a sensitivity of 78.8% and specificity of 73.8%. Patients with CgA levels higher than 46.2 ng/mL had a worse prognosis than patients with CgA levels lower than 46.2 ng/mL (P = 0.045). Notably, a weak correlation was observed between changes in serum CgA levels and clinical response to the IP regimen as well as SSAs. Our data also indicate that serum CgA could be a useful indicator of patient prognosis though there is more research required in order to validate such claims.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood*
  • Chromogranin A / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / blood
  • Neuroendocrine Tumors / pathology*
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / pathology*
  • Stomach Neoplasms / blood
  • Stomach Neoplasms / pathology*
  • Survival Analysis

Substances

  • Biomarkers
  • Chromogranin A

Grants and funding

This work was supported by National Natural Science Foundation of China (grant number: No. 81172110, website: http://www.nsfc.gov.cn/publish/portal1/, the author who received the funding: LS); National High Technology Research and Development Program (grant number: No. 2012AA 02A 504, website: http://www.863.gov.cn/, the author who received the funding: LS); and National Basic Research Program of China (No. 2014CBA02002, website: http://www.973.gov.cn, the author who received the funding: LS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.