title: The role of chromogranin A in the management of patients with phaeochromocytoma.
abstract: OBJECTIVE
  Chromogranin A (CgA) is the most accurate general marker of neuroendocrine tumours. Supranormal CgA concentrations have been recorded in patients with tumours of neuroectodermal origin such as phaeochromocytoma and paraganglioma.
  
  
  METHODS
  The present study was performed to assess the role of CgA determination in the management of patients with phaeochromocytoma, in comparison with urinary catecholamines and their metabolites.
  
  
  METHODS
  The patients studied included 22 cases with phaeochromocytoma at initial presentation or at relapse some years after surgical cure or during follow-up of a malignant phaeochromocytoma. Seventeen patients were evaluated before and after surgical removal of phaeochromocytoma. To assess the specificity of the hormonal parameters, 20 subjects were enrolled as controls; they were from a group of patients referred to our observation for possible phaeochromocytoma and who were subsequently proven not to have the disease.
  
  
  RESULTS
  Urinary epinephrine and norepinephrine were supranormal in 82% and 77% of patients, respectively. Urinary metanephrines and normetanephrines were supranormal in 84% and 89% of patients, respectively. The combination of urinary metanephrine and normetanephrine had a sensitivity of 100% in identifying a phaeochromocytoma. CgA was supranormal in 91% of patients. Combining the results of CgA and urinary catecholamines (epinephrine and norepinephrine), the sensitivity for diagnosis of phaeochromocytoma was 100%. Urinary catecholamines, metabolites (metanephrine and normetanephrine) and CgA levels in patients with malignant phaeochromocytoma did not differ significantly from those of patients with benign lesions. In most cases, CgA normalized after surgery.
  
  
  CONCLUSIONS
  Our results indicate that CgA is a good marker of phaeochromocytoma; measurement of CgA could have a role in the follow-up of patients operated on for phaeochromocytoma.
authors.affiliation: Department of Endocrinology, Ospedale Niguarda Ca Granda, Milan, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Grossrubatscher
authors.forename: Paolo
authors.initials: P
authors.lastname: Dalino
authors.forename: Federico
authors.initials: F
authors.lastname: Vignati
authors.forename: Marcello
authors.initials: M
authors.lastname: Gambacorta
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pugliese
authors.forename: Marco
authors.initials: M
authors.lastname: Boniardi
authors.forename: Ornella
authors.initials: O
authors.lastname: Rossetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marocchi
authors.forename: Michaela
authors.initials: M
authors.lastname: Bertuzzi
authors.forename: Paola
authors.initials: P
authors.lastname: Loli
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood* / Q000601:surgery; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood* / Q000652:urine; D016022:Case-Control Studies; D002395:Catecholamines / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D053379:Chromogranin A / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008676:Metanephrine / Q000652:urine; D008875:Middle Aged; D009647:Normetanephrine / Q000652:urine; D010673:Pheochromocytoma / Q000097:blood* / Q000601:surgery; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D002395:Catecholamines; D053379:Chromogranin A; D009647:Normetanephrine; D008676:Metanephrine