title: Chromogranin A in children with neuroblastoma. Serum concentration parallels disease stage and predicts survival.
abstract: Chromogranin A is an acidic protein costored and coreleased with catecholamines from storage vesicles. Its serum concentration is elevated in patients with peptide-producing endocrine neoplasia. We measured serum chromogranin A at the time of diagnosis in 34 children with all stages of neuroblastoma. With a sensitivity of 91% and specificity of 100%, serum chromogranin A emerged as a useful diagnostic tool for neuroblastoma, comparable to or better than other measurements such as neuron-specific enolase, ferritin, or dopamine-beta-hydroxylase. Mean serum chromogranin A correlated with disease stage (r = 0.76, P less than 0.01). The relationship of prognosis (progression-free survival) to baseline serum chromogranin A, age, and disease stage was determined in 34 patients at risk for relapse, with a median followup period of 18 mo (range, 1-48 mo). The survival rate for patients with lower serum chromogranin A levels (less than 190 ng/ml at the time of diagnosis) was 69%, whereas it was 30% for those with higher chromogranin A levels (P less than 0.05). Furthermore, when subjects were additionally stratified by either age or stage, chromogranin A was an effective prognostic tool in patients who either were older than 1 yr (P less than 0.005) or had more advanced disease (stage III or IV; P less than 0.05). We conclude that serum chromogranin A in neuroblastoma is (a) a valuable (sensitive and specific) diagnostic tool, (b) a correlate of tumor burden, and (c) a useful predictor of survival.
authors.affiliation: Department of Medicine, University of California, San Diego.
authors.forename: R J
authors.initials: RJ
authors.lastname: Hsiao
authors.forename: R C
authors.initials: RC
authors.lastname: Seeger
authors.forename: A L
authors.initials: AL
authors.lastname: Yu
authors.forename: D T
authors.initials: DT
authors.lastname: O'Connor
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging; D009369:Neoplasms / Q000097:blood*; D009419:Nerve Tissue Proteins / Q000097:blood*; D009447:Neuroblastoma / Q000097:blood* / Q000473:pathology; D011379:Prognosis; D011863:Radioimmunoassay; D012016:Reference Values
chemical_list: D014408:Biomarkers, Tumor; C506150:CHGA protein, human; D053379:Chromogranin A; D002864:Chromogranins; D009419:Nerve Tissue Proteins