title: Baseline plasma chromogranin A levels in patients with well-differentiated neuroendocrine tumors of the pancreas: A potential predictor of postoperative recurrence.
abstract: BACKGROUND
  The present study aimed to elucidate prognostic values of baseline plasma chromogranin A (CgA) concentrations in patients with resectable, well-differentiated pancreatic neuroendocrine tumors (PNETs).
  
  
  METHODS
  Preoperative CgA levels in 21 patients with PNET were correlated with clinicopathological factors and patients' survival.
  
  
  RESULTS
  Plasma CgA levels ranged 2.9-30.8 pmol/mL (median 6.0), and were significantly elevated in patients with post-operative recurrence (P = 0.004). Using the receiver operating characteristic curve, the optimal cutoff value to predict tumor recurrence was determined as 17.0 pmol/mL. This threshold identified patients with recurrence with 60% sensitivity, 100% specificity, and 90% overall accuracy. Patients with higher CgA levels showed worse recurrence-free survival than those with low CgA levels, both in total (P < 0.001) and in G2 patients (P = 0.020).
  
  
  CONCLUSIONS
  Combined plasma CgA concentrations and WHO grading may assist in better stratification of PNET patients in terms of the risk of recurrence.
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Nanno
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: toyama@med.kobe-u.ac.jp.
authors.forename: Hirochika
authors.initials: H
authors.lastname: Toyama
authors.affiliation: Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Otani
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Sadaki
authors.initials: S
authors.lastname: Asari
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053379:Chromogranin A / Q000097:blood*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000378:metabolism; D018358:Neuroendocrine Tumors / Q000097:blood / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000097:blood / Q000473:pathology*
chemical_list: D053379:Chromogranin A
keywords: Chromogranin A; Pancreatic cancer; Pancreatic neuroendocrine tumor; Recurrence; Tumor markers