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膵神経内分泌腫瘍(p-NET)

関連論文:
img  24:  Plasma chromogranin A as marker for survival in patients with metastatic endocrine gastroenteropancreatic tumors.
 
著者: Rudolf Arnold, Alexandra Wilke, Anja Rinke, Christina Mayer, Peter Herbert Kann, Klaus-Jochen Klose, André Scherag, Maik Hahmann, Hans-Helge Müller, Peter Barth
雑誌名: Clin Gastroenterol Hepatol. 2008 Jul;6(7):820-7. doi: 10.1016/j.cgh.2008.02.052. Epub 2008 Jun 10.
Abstract/Text 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 log10 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.

PMID 18547872  Clin Gastroenterol Hepatol. 2008 Jul;6(7):820-7. doi: 10.1016/j.cgh.2008.02.052. Epub 2008 Jun 10.
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