Application of serum chromogranin A in clinical diagnosis and efficacy evaluation of gastroenteropancreatic neuroendocrine neoplasm / 中华消化杂志

ABSTRACT

Objective To explore the value of serum chromogranin A (CgA) in clinical diagnosis and efficacy evaluation of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods From January 2011 to December 2012,87 GEP-NEN patients were enrolled,which included 50 patients with lesions and 37 patients without lesions after surgery.Eighty-four healthy subjects were taken as control group.The serum CgA levels of all subjects were measured with enzyme linked immunosorbent assay.Nonparametric test,receiver operating characteristic curve and Cox regression univariate analysis were performed for analysis.Results The median of serum CgA level of GEP-NEN patients with lesions was 97μg/L,which was significantly higher than that of patients without lesions after surgery (42 μg/L,Z=3.451,P=0.001) and healthy control (47 μg/L,Z=3.149,P=0.002).The value of 95 μg/L was taken as diagnostic cut-off value for healthy controls,patients without lesions and patients with lesions,the sensitivity and specificity were 54.0％ and 90.1％,respectively.The median of serum CgA level of the patients with distant metastasis was 231 μg/L,which was higher than that of patients without distant metastasis (46 μg/L,Z=3.340,P=0.001).After treatment,the serum CgA levels of 12 patients with complete remission,partial remission or stable tumor decreased more than 20％ of baseline values.The serum CgA levels of five patients increased more than 20 ％ of baseline values and the tumors of them showed progress.Cox regression analysis showed that there was no correlation between CgA levels of patients with lesions and prognosis (r=1.000,P=0.252).Conclusion Neuroendocrine marker CgA has high diagnostic value in GEP-NEN,and can be used as an important biomarker in clinical diagnosis and efficacy evaluation of GEP-NEN.