Chromogranin A in patients with acid hypersecretion and/or hypergastrinaemia.
BACKGROUND
Chromogranin has been proposed as a marker for gastrin-dependent enterochromaffin-like cell proliferation.


OBJECTIVE
To examine this question in three populations: acid hypersecretors with gastrinoma (Zollinger-Ellison), or without gastrinoma (non-Zollinger-Ellison), and also in pernicious anaemia with achlorhydria-caused hypergastrinaemia.


METHODS
We measured serum chromogranin, gastrin, gastric secretion and counted and quantified hyperplasia of enterochromaffin-like cells in gastric biopsies from 38 Zollinger-Ellison and 13 non-Zollinger-Ellison patients being treated with lansoprazole, for 5 years (median) and again 2.5 years later. We also studied 12 patients with pernicious anaemia, half with gastric enterochromaffin-like cell carcinoids.


RESULTS
Serum chromogranin was elevated in patients with gastrinoma, even without any enterochromaffin-like cell proliferation, but not in non-Zollinger-Ellison acid hypersecretors with normal gastrin (P < 0.001). In the hypersecretors chromogranin correlated well with serum gastrin (r = 0.82), but not with enterochromaffin-like cell proliferation. Moreover, chromogranin was normal or near normal (<75 ng/mL) despite very high serum gastrin in five of six patients with pernicious anaemia and enterochromaffin-like cell carcinoids.


CONCLUSIONS
Chromogranin is not a reliable marker for enterochromaffin-like cell activity or proliferation up to and including carcinoid; chromogranin originates in the gastrinoma and, like gastrin, is a marker for gastrinoma in acid hypersecretors.
Hirschowitz
B I
BI
The University of Alabama at Birmingham, Division of Gastroenterology and Hepatology, University Station, Birmingham, AL 35294-0007, USA. bih@uab.edu
Worthington
J
J
Mohnen
J
J
Haber
M
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use*; D053379:Chromogranin A; D015986:Confounding Factors, Epidemiologic; D004759:Enterochromaffin Cells / Q000378:metabolism; D019861:Enterochromaffin-like Cells / Q000378:metabolism; D005260:Female; D005755:Gastrins / Q000378:metabolism; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy / Q000209:etiology*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D053379:Chromogranin A; D005755:Gastrins; D064747:Lansoprazole