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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

1,†
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1,†
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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 / Revised: 30 January 2012 / Accepted: 10 February 2012 / Published: 15 February 2012
(This article belongs to the Special Issue Neuroendocrine Tumors)
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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 neuroendocrine tumors; gastroenteropancreatic system; sensitivity; chromogranin A; CIS-bio assay; alkaline phosphatase; urinary 5-hydroxyindoleacetic acid; liver metastases
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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Nölting, S.; Kuttner, A.; Lauseker, M.; Vogeser, M.; Haug, A.; Herrmann, K.A.; Hoffmann, J.N.; Spitzweg, C.; Göke, B.; Auernhammer, C.J. Chromogranin A as Serum Marker for Gastroenteropancreatic Neuroendocrine Tumors: A Single Center Experience and Literature Review. Cancers 2012, 4, 141-155.

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