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HPB (Oxford). 2019 May;21(5):612-618. doi: 10.1016/j.hpb.2018.09.016. Epub 2018 Oct 23.

Limited role of Chromogranin A as clinical biomarker for pancreatic neuroendocrine tumors.

Author information

1
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
2
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
3
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
4
Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
5
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
6
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: allenp@mskcc.org.

Abstract

BACKGROUND:

Serum Chromogranin A (CgA) is widely used as a biomarker for pancreatic neuroendocrine tumors (PanNETs). The aim of this study was to investigate the value of CgA as a diagnostic and prognostic marker for well-differentiated PanNETs.

METHODS:

Patients with well-differentiated PanNET and a baseline CgA measurement, between 2011 and 2016 were reviewed. The diagnostic value was determined by comparing CgA values from patients with PanNETs to those with other pancreatic neoplasms and healthy controls. The Kaplan-Meier method was used to investigate the CgA prognostic significance.

RESULTS:

Ninety-nine patients met inclusion criteria. As a diagnostic marker, CgA had a sensitivity of 66%, specificity of 95%, and overall accuracy of 71%. The use of PPIs was associated with a higher CgA level (p = 0.015). When excluding patients on PPIs, CgA accuracy in distinguishing PanNETs from other pancreatic neoplasms was 66%, the sensitivity and specificity were 60% and 75% respectively. Elevated CgA (p = 0.004), Ki67% (p < 0.001), tumor grade (p < 0.001) and stage of disease (p = 0.036) were associated with disease-specific survival.

CONCLUSION:

CgA has a limited role as a diagnostic biomarker for well-differentiated PanNETs. An elevated CgA level may have prognostic value but its role should be further investigated with respect to other known pathological factors.

PMID:
30366884
DOI:
10.1016/j.hpb.2018.09.016

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