title: Diagnostic value of chromogranin A in pancreatic neuroendocrine tumors depends on tumor size: A prospective observational study from a single institute.
abstract: Chromogranin A has recently been recommended as the most practical tumor marker in patients with pancreatic neuroendocrine tumors. However, the diagnostic effectiveness of circulating chromogranin A levels remains controversial. Here, we aimed to assess the clinical diagnostic value of plasma chromogranin A levels for pancreatic neuroendocrine tumors.
  
  
  
  Between June 2012 and June 2015, 110 consecutive patients with a suspected pancreatic neuroendocrine tumor were prospectively enrolled. We evaluated the diagnostic value of the chromogranin A assay for differentiating pancreatic neuroendocrine tumors from other tumors. The plasma chromogranin A levels in the pancreatic neuroendocrine tumor patients were examined according to various clinicopathologic factors.
  
  
  
  A total of 65 patients were diagnosed as having pancreatic neuroendocrine tumors, whereas 45 had other tumors. The median chromogranin A level in pancreatic neuroendocrine tumor cases was higher than that in cases of other tumors (pancreatic neuroendocrine tumors: 126.62 ng/mL, other tumors: 69.82 ng/mL). The sensitivity, specificity, and accuracy of the chromogranin A assay for pancreatic neuroendocrine tumor diagnosis were 49.2%, 77.8%, and 60.9%, respectively. The chromogranin A levels after operative resection were reduced or were confirmed as being within the normal range (78.9%) in most cases. Moreover, the chromogranin A level in pancreatic neuroendocrine tumors cases was correlated with tumor size based on comparisons with other tumors in the pancreas (P = .038). The sensitivity, specificity, and accuracy of the chromogranin A assay for large tumors were greater, at 64.3%, 100.0%, and 81.5%, respectively.
  
  
  
  In clinical settings, the identification of pancreatic neuroendocrine tumors is vital for the development of therapeutic strategies. In large pancreatic tumors, the measurement of chromogranin A levels is very useful for distinguishing pancreatic neuroendocrine tumors from other tumors in the pancreas.
authors.affiliation: Department of Biomedical Sciences, University of Ulsan College of Medicine, Seoul, South Korea; Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Eunsung
authors.initials: E
authors.lastname: Jun
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea. Electronic address: drksc@amc.seoul.kr.
authors.forename: Song Cheol
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Ki Byung
authors.initials: KB
authors.lastname: Song
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Seung Mo
authors.initials: SM
authors.lastname: Hong
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Park
authors.affiliation: Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D053379:Chromogranin A / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A