title: Chromogranin A (CgA) serum level as a marker of progression in hepatocellular carcinoma (HCC) of elderly patients.
abstract: The observation of neuroendocrine (NE) activity during clinical course of hepatocellular carcinoma (HCC), suggested the use of NE serum markers to detect it. Thus we have evaluated the usefulness of serum measurements of CgA in monitoring disease activity of HCC. We investigated the role of serum concentrations of CgA, alpha-fetoprotein (AFP) and des-gamma-carboxyl-prothrombin (DCP) in 55 patients with HCC, 27 patients with cirrhosis, 22 patients with chronic hepatitis and a control group of 20 volunteers and the relationship between the pre-treatment serum CgA and clinical stages of the disease. CgA was significantly higher in the patients affected by HCC as compared with those affected by either hepatitis or cirrhosis (p<0.001). We also observed significant differences, comparing CgA serum levels in the tumor classes T1-T4: T1 vs. T2 (p<0.001), T1 vs. T3 (p<0.001), T1 vs. T4 (p<0.001), T2 vs. T3 (p<0.001), T2 vs. T4 (p<0.001) and T3 vs. T4 (p<0.001). CgA levels were significantly higher in poorly differentiated HCC vs. well differentiated (p<0.05) and medium differentiated ones (p<0.001). Also the comparison between Child-Pugh degree A and C showed a significant difference in CgA levels (p<0.001). Thereby, patients with higher CgA level had poor survival and showed poor prognosis, compared to those with lower CgA level, i.e., the CgA is useful in monitoring progression of disease and may assist as a prognostic indicator.
authors.affiliation: Department of Senescence, Urological and Neurological Sciences, Cannizzaro Hospital, University of Catania, Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malaguarnera
authors.forename: Marco
authors.initials: M
authors.lastname: Vacante
authors.forename: Rosangela
authors.initials: R
authors.lastname: Fichera
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cappellani
authors.forename: Erika
authors.initials: E
authors.lastname: Cristaldi
authors.forename: Massimo
authors.initials: M
authors.lastname: Motta
mesh_terms: D000368:Aged; D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology*; D053379:Chromogranin A / Q000097:blood*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D015415:Biomarkers; D053379:Chromogranin A; D000509:alpha-Fetoproteins