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• Nölting, S
• Kuttner, A
• Lauseker, M
• Vogeser, M
• Haug, A
• Herrmann, K
• Hoffmann, J
• Spitzweg, C
• Göke, B
• Auernhammer, C
• [+] on Google Scholar
• Nölting, S
• Kuttner, A
• Lauseker, M
• Vogeser, M
• Haug, A
• Herrmann, K
• Hoffmann, J
• Spitzweg, C
• Göke, B
• Auernhammer, C
• [+] on PubMed
• Nölting, S
• Kuttner, A
• Lauseker, M
• Vogeser, M
• Haug, A
• Herrmann, K
• Hoffmann, J
• Spitzweg, C
• Göke, B
• Auernhammer, C

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Cancers 2012, 4(1), 141-155; doi:10.3390/cancers4010141

Article

Chromogranin A as Serum Marker for Gastroenteropancreatic Neuroendocrine Tumors: A Single Center Experience and Literature Review

Svenja Nölting ^1,† , Axel Kuttner ^1,† , Michael Lauseker ² , Michael Vogeser ³ , Alexander Haug ⁴ , Karin A. Herrmann ⁵ , Johannes N. Hoffmann ⁶ , Christine Spitzweg ¹ , Burkhard Göke ¹  and Christoph J. Auernhammer ^1,*

¹ Department of Internal Medicine II, Campus Grosshadern, University-Hospital of the Ludwig-Maximilians-University of Munich, Munich 81377, Germany ² Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich 81377, Germany ³ Department of Clinical Chemistry, Campus Grosshadern, University-Hospital of the Ludwig-Maximilian-University of Munich, Munich 81377, Germany ⁴ Clinic of Nuclear Medicine, Campus Grosshadern, University-Hospital of the Ludwig Maximilian-University of Munich, Munich 81377, Germany ⁵ Institute of Radiology, Campus Grosshadern, University-Hospital of the Ludwig Maximilian-University of Munich, Munich 81377, Germany ⁶ Department of Surgery, Campus Grosshadern, University-Hospital of the Ludwig Maximilians-University of Munich, Munich 81377, Germany ^† These authors contributed equally to this work.

* Author to whom correspondence should be addressed.

Received: 30 December 2011; in revised form: 30 January 2012 / Accepted: 10 February 2012 / Published: 15 February 2012

(This article belongs to the Special Issue Neuroendocrine Tumors)

Download PDF Full-Text [160 KB, uploaded 15 February 2012 09:23 CET]

Abstract: The aim of this study was to assess the clinical sensitivities of the tumor markers chromogranin A (CgA), urinary 5-hydroxyindoleacetic acid (5-HIAA) and alkaline phosphatase (AP) in neuroendocrine tumors (NETs) of the GastroEnteroPancreatic-(GEP-) system depending on tumor primary location and metastatic spread. In a retrospective single-center series, sensitivities were evaluated in serum samples from 110 patients with midgut (n = 62) and pancreatic (n = 48) NETs. CgA levels were analyzed by a commercially-available immunoradiometric assay (CIS-bio) during routine follow-up in the years 2000–2009. CgA showed a higher sensitivity for midgut (68%) than pancreatic (54%) NETs. A higher CgA sensitivity and significantly higher median CgA values were found in patients with liver metastases than in those without, and in patients with hepatic and additionally extra-hepatic metastases than in those with hepatic and nodal metastases alone, respectively. We found an overall sensitivity for elevated 5HIAA excretion of 69% for midgut NETs and a significant correlation between median CgA and 5-HIAA values. The sensitivity of AP and the correlations of AP/CgA-data-pairs were low in both midgut and pancreatic NETs, although highest for metastatic pancreatic NETs. The sensitivity of CgA measurement depends on the NET primary location and spread of disease. 5-HIAA and CgA showed comparable sensitivity in midgut NETs, while AP does not seem to be useful as a tumor marker in GEP-NETs.

Keywords: neuroendocrine tumors; gastroenteropancreatic system; sensitivity; chromogranin A; CIS-bio assay; alkaline phosphatase; urinary 5-hydroxyindoleacetic acid; liver metastases

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