SERUM CHROMOGRANIN–А LEVELS IN NEUROENDOCRINE NEOPLASMS AS PROGNOSTIC MARKER IN CORRELATION WITH THE CLINICAL COURSE OF THE DISEASE AND THE INFLUENCE OF OCTREOTID THERAPY
Keywords:
chromogranin A, ELISA, octreotide therapyAbstract
Neuroendocrine neplasms (NEN) arise from neuroedocrine cells in various tissues and organs, have diverse biological behavior and express neuroendocrine markers synaptophysin and chromogranin A (CgA).
The aim of this study was to correlate the serum CgA levels before and after surgical and/or oncological treatment with octreotide and to determine the prognostic value of CgA variations during the follow-up.
We used ELISA to analyze 699 serum samples from 410 patients during 9 years, due to carcinoid syndrome, benign neuroendocrine tumor (NET), localized neuroendocrine carcinoma (NEC) and patients with metastatic NEC (MS).
Data from hospital databases were used for follow-up of 60 patients, divided into responders and non-responders, regarding their response to therapy.
The mean serum CgA value in 410 analyzed patients was by 3.47-fold increase compared to the maximal reference values. The highest increase was measured in patients with NEC/MS, with mean 12.94-fold increase, followed by patients with localized NECs, with mean 4.57. During follow-up, CgA values were reduced, with a significant difference between the groups of responders and non-responders.
Reduction of the CgA level for at least 49.5% during the first 12 months after therapy was correlated with stable disease course, and serum CgA elevation or decrease less than 34% during the first 12 months after the therapy was correlated to unfavorable clinical course. Serum CgA levels are useful for the diagnosis of NENs and during the follow-up for detection of recurrence, disease progression and evaluation of the oncologic therapy response.
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