Blood Chromogranin A Is Not Effective as a Biomarker for Diagnosis or Management of Bronchopulmonary Neuroendocrine Tumors/Neoplasms
| العنوان: | Blood Chromogranin A Is Not Effective as a Biomarker for Diagnosis or Management of Bronchopulmonary Neuroendocrine Tumors/Neoplasms |
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| المؤلفون: | Matteo Roffinella, Agnieszka Kolasińska-Ćwikła, Lisa Bodei, Beata Kos-Kudła, Anna Malczewska, Anna Lewczuk-Myślicka, Somer Matar, Pier Luigi Filosso, Irvin M. Modlin, Alejandro L Suarez, Ignat Drozdov, Jarosław B. Ćwikła, Mark Kidd, Harry R. Aslanian, Kjell Öberg |
| المصدر: | Neuroendocrinology |
| بيانات النشر: | S. Karger AG, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, endocrine system, medicine.medical_specialty, Lung Neoplasms, Adolescent, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Carcinoid Tumor, Disease, Neuroendocrine tumors, Gastroenterology, Article, 030218 nuclear medicine & medical imaging, Young Adult, 03 medical and health sciences, Cellular and Molecular Neuroscience, Idiopathic pulmonary fibrosis, 0302 clinical medicine, Endocrinology, Stable Disease, Internal medicine, Biomarkers, Tumor, Humans, Medicine, Aged, Aged, 80 and over, Lung, biology, Receiver operating characteristic, Endocrine and Autonomic Systems, business.industry, Chromogranin A, Middle Aged, Prognosis, medicine.disease, Neuroendocrine Tumors, medicine.anatomical_structure, biology.protein, Biomarker (medicine), Female, business |
| الوصف: | Background: Identification of circulating tumor markers for clinical management in bronchopulmonary (BP) neuroendocrine tumors/neoplasms (NET/NEN) is of considerable clinical interest. Chromogranin A (CgA), a “universal” NET biomarker, is considered controversial as a circulating biomarker of BPNEN. Aim: Assess utility of CgA in the diagnosis and management of BPNEN in a multicentric study. Material and Methods: CgA diagnostic metrics were assessed in lung NET/NENs (n = 200) and controls (n = 140), randomly assigned to a Training and Test set (100 BPC and 70 controls in each). Assay specificity was evaluated in neoplastic lung disease (n = 137) and nonneoplastic lung disease (n = 77). CgA efficacy in predicting clinical status was evaluated in the combined set of 200 NET/NENs. CgA levels in bronchopulmonary neuroendocrine tumor (BPNET) subtypes (atypical [AC] vs. typical [TC]) and grade was examined. The clinical utility of an alteration of CgA levels (±25%) was evaluated in a subset of 49 BPNET over 12 months. CgA measurement was by NEOLISATM kit (EuroDiagnostica). Results: Sensitivity and specificity in the training set were 41/98%, respectively. Test set data were 42/87%. Training set area under receiver operator characteristic analysis differentiated BPC from control area under the curve (AUC) 0.61 ± 0.05 p = 0.015. Test set the data were AUC 0.58 ± 0.05, p = 0.076. In the combined set (n = 200), 67% BPNET/NEN (n = 134) had normal CgA levels. CgA levels did not distinguish histological subtypes (TC vs. AC, AUC 0.56 ± 0.04, p = 0.21), grade (p = 0.45–0.72), or progressive from stable disease (AUC 0.53 ± 0.05 p = 0.47). There was no correlation of CgA with Ki-67 index (Pearson r = 0.143, p = 0.14). For nonneoplastic diseases (chronic obstructive pulmonary disorder and idiopathic pulmonary fibrosis), CgA was elevated in 26–37%. For neoplastic disease (NSCLC, squamous cell carcinoma), CgA was elevated in 11–16%. The neuroendocrine SCLC also exhibited elevated CgA (50%). Elevated CgA was not useful for differentiating BPNET/NEN from these other pathologies. Monitoring BPNET/NEN over a 12-month period identified neither CgA levels per se nor changes in CgA were reflective of somatostatin analog treatment outcome/efficacy or the natural history of the disease (progression). Conclusions: Blood CgA levels are not clinically useful as a biomarker for lung BPNET/NEN. The low specificity and elevations in both nonneoplastic as well as other common neoplastic lung diseases identified limited clinical utility for this biomarker. |
| تدمد: | 1423-0194 0028-3835 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5a38ad265dd93474080d29db70ee92b2 https://doi.org/10.1159/000500202 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5a38ad265dd93474080d29db70ee92b2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14230194 00283835 |
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