Chromogranin A, neuron specific enolase, carcinoembryonic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors

Emilio Bajetta, Leonardo Ferrari, Antonia Martinetti, Luigi Celio, Giuseppe Procopio, Salvatore Artale, Nicoletta Zilembo, Maria Di Bartolomeo, Ettore Seregni, Emilio Bombardieri

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Chromogranin A (CgA), neuron specific enolase (NSE), carcinoembryonic antigen (CEA), and urinary 5-hydroxyindole-3-acetic acid (5- HIAA) are the markers currently used in the diagnosis, prognosis, and follow- up of patients with neuroendocrine tumors (NETs). The authors examined the role of such biomarkers in a large series of patients with NETs. METHODS. One hundred and twenty-seven patients entered the study. Multiple blood and 24- hour urine specimens were assayed for biomarker quantitation. RESULTS. The accuracy of each marker was assessed in patients with (n = 106) and without (n = 21) disease. CgA proved to be the best marker (specificity of 85.7% and sensitivity of 67.9%). Patients with disease had significantly higher CgA and NSE levels compared with disease free patients (P = 0.00003 and P = 0.00240, respectively). NSE and 5-HIAA determination showed a very high specificity (100%) but a rather low sensitivity (32.9% and 35.1%, respectively). CEA was found to have little diagnostic value (sensitivity of 15.4%). CgA was the most sensitive marker for detecting patients with disseminated disease and 5- HIAA displayed the highest sensitivity in identifying syndromic patients. Tumor marker modifications were studied during follow-up. In particular, rises in CgA were associated with progressive disease in 83.3% of cases and stable CgA was associated with stable disease in 53.8% of cases. The relation between CgA modifications and liver lesions during follow-up also was studied; increases in CgA levels were associated with local progression in 100% of cases and stable marker levels were found in 68.7% of the patients with unchanged lesions. CONCLUSIONS. The results of the current study demonstrate that CgA has the highest accuracy and is the most reliable biomarker reflecting the clinical evolution of NETs.

Original languageEnglish
Pages (from-to)858-865
Number of pages8
JournalCancer
Volume86
Issue number5
DOIs
Publication statusPublished - Sep 1 1999

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Chromogranin A
Neuroendocrine Tumors
Phosphopyruvate Hydratase
Carcinoembryonic Antigen
Acetic Acid
Biomarkers
Hydroxyindoleacetic Acid
Tumor Biomarkers
Urine
Sensitivity and Specificity

Keywords

  • 5-hydroxyindole-3-acetic acid
  • Carcinoembryonic antigen
  • Chromogranin A
  • Neuroendoerine tumors
  • Neuron specific enolase
  • Tumor markers

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{e88234c31a684abda4a292e7122c1d3a,
title = "Chromogranin A, neuron specific enolase, carcinoembryonic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors",
abstract = "BACKGROUND. Chromogranin A (CgA), neuron specific enolase (NSE), carcinoembryonic antigen (CEA), and urinary 5-hydroxyindole-3-acetic acid (5- HIAA) are the markers currently used in the diagnosis, prognosis, and follow- up of patients with neuroendocrine tumors (NETs). The authors examined the role of such biomarkers in a large series of patients with NETs. METHODS. One hundred and twenty-seven patients entered the study. Multiple blood and 24- hour urine specimens were assayed for biomarker quantitation. RESULTS. The accuracy of each marker was assessed in patients with (n = 106) and without (n = 21) disease. CgA proved to be the best marker (specificity of 85.7{\%} and sensitivity of 67.9{\%}). Patients with disease had significantly higher CgA and NSE levels compared with disease free patients (P = 0.00003 and P = 0.00240, respectively). NSE and 5-HIAA determination showed a very high specificity (100{\%}) but a rather low sensitivity (32.9{\%} and 35.1{\%}, respectively). CEA was found to have little diagnostic value (sensitivity of 15.4{\%}). CgA was the most sensitive marker for detecting patients with disseminated disease and 5- HIAA displayed the highest sensitivity in identifying syndromic patients. Tumor marker modifications were studied during follow-up. In particular, rises in CgA were associated with progressive disease in 83.3{\%} of cases and stable CgA was associated with stable disease in 53.8{\%} of cases. The relation between CgA modifications and liver lesions during follow-up also was studied; increases in CgA levels were associated with local progression in 100{\%} of cases and stable marker levels were found in 68.7{\%} of the patients with unchanged lesions. CONCLUSIONS. The results of the current study demonstrate that CgA has the highest accuracy and is the most reliable biomarker reflecting the clinical evolution of NETs.",
keywords = "5-hydroxyindole-3-acetic acid, Carcinoembryonic antigen, Chromogranin A, Neuroendoerine tumors, Neuron specific enolase, Tumor markers",
author = "Emilio Bajetta and Leonardo Ferrari and Antonia Martinetti and Luigi Celio and Giuseppe Procopio and Salvatore Artale and Nicoletta Zilembo and {Di Bartolomeo}, Maria and Ettore Seregni and Emilio Bombardieri",
year = "1999",
month = "9",
day = "1",
doi = "10.1002/(SICI)1097-0142(19990901)86:5<858::AID-CNCR23>3.0.CO;2-8",
language = "English",
volume = "86",
pages = "858--865",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Chromogranin A, neuron specific enolase, carcinoembryonic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors

AU - Bajetta, Emilio

AU - Ferrari, Leonardo

AU - Martinetti, Antonia

AU - Celio, Luigi

AU - Procopio, Giuseppe

AU - Artale, Salvatore

AU - Zilembo, Nicoletta

AU - Di Bartolomeo, Maria

AU - Seregni, Ettore

AU - Bombardieri, Emilio

PY - 1999/9/1

Y1 - 1999/9/1

N2 - BACKGROUND. Chromogranin A (CgA), neuron specific enolase (NSE), carcinoembryonic antigen (CEA), and urinary 5-hydroxyindole-3-acetic acid (5- HIAA) are the markers currently used in the diagnosis, prognosis, and follow- up of patients with neuroendocrine tumors (NETs). The authors examined the role of such biomarkers in a large series of patients with NETs. METHODS. One hundred and twenty-seven patients entered the study. Multiple blood and 24- hour urine specimens were assayed for biomarker quantitation. RESULTS. The accuracy of each marker was assessed in patients with (n = 106) and without (n = 21) disease. CgA proved to be the best marker (specificity of 85.7% and sensitivity of 67.9%). Patients with disease had significantly higher CgA and NSE levels compared with disease free patients (P = 0.00003 and P = 0.00240, respectively). NSE and 5-HIAA determination showed a very high specificity (100%) but a rather low sensitivity (32.9% and 35.1%, respectively). CEA was found to have little diagnostic value (sensitivity of 15.4%). CgA was the most sensitive marker for detecting patients with disseminated disease and 5- HIAA displayed the highest sensitivity in identifying syndromic patients. Tumor marker modifications were studied during follow-up. In particular, rises in CgA were associated with progressive disease in 83.3% of cases and stable CgA was associated with stable disease in 53.8% of cases. The relation between CgA modifications and liver lesions during follow-up also was studied; increases in CgA levels were associated with local progression in 100% of cases and stable marker levels were found in 68.7% of the patients with unchanged lesions. CONCLUSIONS. The results of the current study demonstrate that CgA has the highest accuracy and is the most reliable biomarker reflecting the clinical evolution of NETs.

AB - BACKGROUND. Chromogranin A (CgA), neuron specific enolase (NSE), carcinoembryonic antigen (CEA), and urinary 5-hydroxyindole-3-acetic acid (5- HIAA) are the markers currently used in the diagnosis, prognosis, and follow- up of patients with neuroendocrine tumors (NETs). The authors examined the role of such biomarkers in a large series of patients with NETs. METHODS. One hundred and twenty-seven patients entered the study. Multiple blood and 24- hour urine specimens were assayed for biomarker quantitation. RESULTS. The accuracy of each marker was assessed in patients with (n = 106) and without (n = 21) disease. CgA proved to be the best marker (specificity of 85.7% and sensitivity of 67.9%). Patients with disease had significantly higher CgA and NSE levels compared with disease free patients (P = 0.00003 and P = 0.00240, respectively). NSE and 5-HIAA determination showed a very high specificity (100%) but a rather low sensitivity (32.9% and 35.1%, respectively). CEA was found to have little diagnostic value (sensitivity of 15.4%). CgA was the most sensitive marker for detecting patients with disseminated disease and 5- HIAA displayed the highest sensitivity in identifying syndromic patients. Tumor marker modifications were studied during follow-up. In particular, rises in CgA were associated with progressive disease in 83.3% of cases and stable CgA was associated with stable disease in 53.8% of cases. The relation between CgA modifications and liver lesions during follow-up also was studied; increases in CgA levels were associated with local progression in 100% of cases and stable marker levels were found in 68.7% of the patients with unchanged lesions. CONCLUSIONS. The results of the current study demonstrate that CgA has the highest accuracy and is the most reliable biomarker reflecting the clinical evolution of NETs.

KW - 5-hydroxyindole-3-acetic acid

KW - Carcinoembryonic antigen

KW - Chromogranin A

KW - Neuroendoerine tumors

KW - Neuron specific enolase

KW - Tumor markers

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