title: Serum and ascites chromogranin-A in patients with metastatic neuroendocrine tumors.
abstract: OBJECTIVE
  Ascites secondary to neuroendocrine tumor metastases may arise from a variety of mechanisms. Our aim was to measure serum and ascitic chromogranin-A (CgA) to help determine whether ascites resulted from intraperitoneal/retroperitoneal disease burden or from other carcinoid complications such as congestive heart failure or portal hypertension.
  
  
  METHODS
  Patients with metastatic neuroendocrine tumors and ascites were identified. Chromogranin-A was obtained and measured from both serum and ascites. The causes of carcinoid ascites was categorized into 2 groups: high intraperitoneal or retroperitoneal disease burden (ie, peritoneal metastases and/or lymphatic obstruction; n = 12, group 1) or other organ-specific carcinoid complications such as CHF or portal hypertension (n = 12, group 2).
  
  
  RESULTS
  An ascites CgA/serum CgA ratio greater than 1 was more likely to be found in group 1 (P = 0.01). This ratio produced 100% sensitivity and 75% specificity for ascites secondary to peritoneal metastases and/or lymphatic obstruction.
  
  
  CONCLUSIONS
  An ascites CgA/serum CgA ratio greater than 1 produces excellent accuracy in predicting peritoneal metastases and/or retroperitoneal disease as the cause of ascites in the setting of metastatic carcinoid. This test may play a role in the earlier identification of those patients who may be well served by aggressive management.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Center for Carcinoid and Neuroendocrine Tumors, New York, NY 10029, USA.
authors.forename: Richard R P
authors.initials: RR
authors.lastname: Warner
authors.forename: Thomas
authors.initials: T
authors.lastname: Curran
authors.forename: Michail K
authors.initials: MK
authors.lastname: Shafir
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
authors.forename: Viktoriya
authors.initials: V
authors.lastname: Khaitova
authors.forename: Michelle Kang
authors.initials: MK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000378:metabolism* / Q000473:pathology; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000556:secondary; D053379:Chromogranin A / Q000032:analysis* / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000097:blood* / Q000473:pathology; D012680:Sensitivity and Specificity; D016019:Survival Analysis
chemical_list: D053379:Chromogranin A