Plasma chromogranin A in patients with multiple endocrine neoplasia type 1.
Plasma chromogranin A (CgA) has been claimed to be a sensitive marker for neuroendocrine tumors, but its role in the early diagnosis of multiple endocrine neoplasia type 1 (MEN 1) pancreatic endocrine tumors has not been evaluated. We measured CgA in 36 patients with MEN 1, of whom 9 lacked pancreatic involvement, 20 had biochemical evidence of pancreatic endocrine tumors, and 7 displayed radiologically detectable pancreatic tumors. CgA was also analyzed in 25 patients with sporadic pancreatic endocrine tumors, 39 subjects with inflammatory bowel disease, 7 patients harboring nonendocrine pancreatic disease, and 19 healthy controls. Four of 9 of the MEN 1 patients without pancreatic involvement had elevated CgA. Furthermore, 60% with biochemically unequivocal tumors and all with a radiologically visible tumor showed elevations. All 25 patients with sporadic pancreatic endocrine tumor had increased CgA, as had 28% of patients with inflammatory bowel disease and 57% with nonendocrine pancreatic disease. Mean day to day CgA variation was 29% (range, 0-113%) in the neuroendocrine tumor patients and 21.0% (range, 0.0-47%, within reference range) among healthy controls. In summary, nonendocrine diseases may cause elevation of CgA, and its spontaneous variation can be considerable. Plasma chromogranin A is the most sensitive of the basal markers for neuroendocrine tumors, but cannot replace other established measures when screening for early pancreatic involvement in MEN 1.
Granberg
D
D
Department of Medical Sciences, University Hospital, Uppsala, Sweden.
Stridsberg
M
M
Seensalu
R
R
Eriksson
B
B
Lundqvist
G
G
Oberg
K
K
Skogseid
B
B
D000328:Adult; D000368:Aged; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000097:blood*; D010190:Pancreatic Neoplasms / Q000097:blood*; D010195:Pancreatitis / Q000097:blood
C506150:CHGA protein, human; D053379:Chromogranin A; D002864:Chromogranins