Is True Non-Secretion of Chromogranin A an Unfavorable Prognostic Factor in Patients with ENETs TNM Stage IV Gastroenteropancreatic Neuroendocrine Tumors?

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Introduction: Chromogranin A (CgA) is the best available serum marker for the work-up of gastroenteropancreatic NETs (GEP-NETs) and correlates with tumor volume & biological activity. During diagnosis & follow-up we found patients with elevated CgA levels and patients without elevated CgA levels (=‘true non-secretors’). We postulated that lack of secretion is a sign of dedifferentiation with a poorer prognosis.

Aim(s): To determine whether true non-secretion of CgA is an unfavorable prognostic factor in patients with ENETs TNM Stage IV GEP-NETs.

Materials and methods: Patients using PPIs & MEN-1 patients were excluded. Baseline & follow-up CgA were measured in a large single-center cohort with one assay (IRMA). Cut-off values for baseline & follow-up CgA: normal (reference range (RR)), intermediate (≤ 2x upper limit of normal (ULN)), high (2-10x ULN) and very high (>10x ULN). Overall survival (OS) was estimated using Kaplan–Meier methods & hazard ratios with a Cox proportional hazards model.

Conference: 13th Annual ENETSConcerence (2016)

Presenting Author: Kamp K

Authors: Kamp K, Adrichem van R, Vandamme T, Peeters M, Feelders R,

Keywords: GEP-NET, CgA, prognosis,