title: Chromogranin a as serum marker for gastroenteropancreatic neuroendocrine tumors: a single center experience and literature review.
abstract: The aim of this study was to assess the clinical sensitivities of the tumor markers chromogranin A (CgA), urinary 5-hydroxyindoleacetic acid (5-HIAA) and alkaline phosphatase (AP) in neuroendocrine tumors (NETs) of the GastroEnteroPancreatic-(GEP-) system depending on tumor primary location and metastatic spread. In a retrospective single-center series, sensitivities were evaluated in serum samples from 110 patients with midgut (n = 62) and pancreatic (n = 48) NETs. CgA levels were analyzed by a commercially-available immunoradiometric assay (CIS-bio) during routine follow-up in the years 2000-2009. CgA showed a higher sensitivity for midgut (68%) than pancreatic (54%) NETs. A higher CgA sensitivity and significantly higher median CgA values were found in patients with liver metastases than in those without, and in patients with hepatic and additionally extra-hepatic metastases than in those with hepatic and nodal metastases alone, respectively. We found an overall sensitivity for elevated 5HIAA excretion of 69% for midgut NETs and a significant correlation between median CgA and 5-HIAA values. The sensitivity of AP and the correlations of AP/CgA-data-pairs were low in both midgut and pancreatic NETs, although highest for metastatic pancreatic NETs. The sensitivity of CgA measurement depends on the NET primary location and spread of disease. 5-HIAA and CgA showed comparable sensitivity in midgut NETs, while AP does not seem to be useful as a tumor marker in GEP-NETs.
authors.affiliation: Department of Internal Medicine II, Campus Grosshadern, University-Hospital of the Ludwig-Maximilians-University of Munich, Munich 81377, Germany. christoph.auernhammer@med.uni-muenchen.de.
authors.forename: Svenja
authors.initials: S
authors.lastname: Nölting
authors.forename: Axel
authors.initials: A
authors.lastname: Kuttner
authors.forename: Michael
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authors.lastname: Lauseker
authors.forename: Michael
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authors.lastname: Vogeser
authors.forename: Alexander
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authors.forename: Johannes N
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authors.forename: Christine
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authors.lastname: Spitzweg
authors.forename: Burkhard
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authors.lastname: Göke
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Auernhammer