Plasma chromogranin A as marker for survival in patients with metastatic endocrine gastroenteropancreatic tumors

被引:162
作者
Arnold, Rudolf [1 ]
Wilke, Alexandra [1 ]
Rinke, Anja [1 ]
Mayer, Christina [1 ]
Kann, Peter Herbert [1 ]
Klose, Klaus-Jochen [2 ]
Scherag, Andre [3 ,4 ]
Hahmann, Maik [5 ]
Mueller, Hans-Helge [3 ]
Barth, Peter [6 ]
机构
[1] Univ Marburg, Dept Internal Med, Div Gastroenterol & Endocrinol, D-3550 Marburg, Germany
[2] Univ Marburg, Dept Radiol, D-3550 Marburg, Germany
[3] Univ Marburg, Inst Med Biometry & Epidemiol, D-3550 Marburg, Germany
[4] Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany
[5] Univ Marburg, Coordinating Ctr Clin Trials KKS, D-3550 Marburg, Germany
[6] Univ Marburg, Dept Pathol, D-3550 Marburg, Germany
关键词
D O I
10.1016/j.cgh.2008.02.052
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: The prognostic role of plasma chromogranin A in patients with neuroendocrine tumors is unclear. We investigated the role of chromogranin A in predicting survival and hypothesized that chromogranin A mirrors tumor burden and that a rapid increase after a phase of stable plasma chromogranin A levels might predict exploding tumor growth. Methods: Three hundred forty-four patients with metastatic, well-differentiated neuroendocrine tumors were included. A subsample of 102 patients was investigated to correlate radiologically classified tumor burden with plasma chromogranin A. Hepatic tumor burden (0%, 0%-25%, 25%-50%, > 50%) was assessed from computed tomography/magnetic resonance imaging scans. Follow-up information until death was generated in regular intervals. Results: Plasma chromogranin A levels (U/L) vary between tumor entities (Kruskal-Wallis, P < .001) and were associated with survival time (hazard ratio [hours], 2.14 per one unit in the log(10) CgA level scale; 95% confidence interval [CI], 1.75-2.62; P < .001). Chromogranin A levels correlated with hepatic tumor burden (Spearman P = .57; 95% CI, 0.44-0.70; P < .001). Additional extrahepatic tumor load did not relevantly affect plasma chromogranin A. A sudden increase observed in individual patients was paralleled by rapid tumor progress and short survival. Conclusions: Increased plasma chromogranin A in patients with metastatic neuroendocrine tumors is predictive for shorter survival. There was a modest correlation between chromogranin A levels and hepatic tumor burden. We hypothesized further that a sudden increase in individual chromogranin A levels indicates unfavorable outcome.
引用
收藏
页码:820 / 827
页数:8
相关论文
共 27 条
[1]   The importance of the measurement of circulating markers in patients with neuroendocrine tumours of the pancreas and gut [J].
Ardill, JES ;
Erikkson, B .
ENDOCRINE-RELATED CANCER, 2003, 10 (04) :459-462
[2]   Octreotide versus octreotide plus interferon-alpha in endocrine gastroenteropancreatic tumors:: A randomized trial [J].
Arnold, R ;
Rinke, A ;
Klose, KJ ;
Müller, HH ;
Wied, M ;
Zamzow, K ;
Schmidt, C ;
Schade-Brittinger, C ;
Barth, P ;
Moll, R ;
Koller, M ;
Unterhalt, M ;
Hiddemann, W ;
Schmidt-Lauber, M ;
Pavel, M ;
Arnold, CN .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2005, 3 (08) :761-771
[3]   Treatment of neuroendocrine GEP tumours with somatostatin analogues - A review [J].
Arnold, R ;
Simon, B ;
Wied, M .
DIGESTION, 2000, 62 :84-91
[4]   Prospective study of the ability of histamine, serotonin or serum chromogranin A levels to identify gastric carcinoids in patients with gastrinomas [J].
Bashir, S ;
Gibril, F ;
Ojeaburu, JV ;
Asgharian, B ;
Entsuah, LK ;
Ferraro, G ;
Crafa, P ;
Bordi, C ;
Jensen, RT .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2002, 16 (07) :1367-1382
[5]   Parametric biomedical imaging -: What defines the quality of quantitative radiological approaches? [J].
Glueer, C.-C. ;
Barkmann, R. ;
Hahn, H. K. ;
Majumdar, S. ;
Eckstein, F. ;
Nickelsen, T. N. ;
Bolte, H. ;
Dicken, V. ;
Heller, M. .
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 2006, 178 (12) :1187-1201
[6]  
GODWIN JD, 1975, CANCER, V36, P560, DOI 10.1002/1097-0142(197508)36:2<560::AID-CNCR2820360235>3.0.CO
[7]  
2-4
[8]  
Goebel SU, 1999, CANCER-AM CANCER SOC, V85, P1470
[9]   ALPHA-SUBUNIT AND HUMAN CHORIONIC GONADOTROPIN-BETA IMMUNOREACTIVITY IN PATIENTS WITH MALIGNANT ENDOCRINE GASTROENTEROPANCREATIC TUMORS [J].
GROSSMANN, M ;
TRAUTMANN, ME ;
POERTL, S ;
HOERMANN, R ;
BERGER, P ;
ARNOLD, R ;
MANN, K .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1994, 24 (02) :131-136
[10]   CHROMOGRANIN-A IN CHILDREN WITH NEUROBLASTOMA - SERUM CONCENTRATION PARALLELS DISEASE STAGE AND PREDICTS SURVIVAL [J].
HSIAO, RJ ;
SEEGER, RC ;
YU, AL ;
OCONNOR, DT .
JOURNAL OF CLINICAL INVESTIGATION, 1990, 85 (05) :1555-1559