Plasma Chromogranin A(CgA) and Urinary 5 Hydroxy-indoleacetic acid(5-HIAA) use in monitoring somatostatin analogue(SSA) therapy at Newcastle NHS Foundation Trust

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Introduction: Two main biochemical markers, plasma chromogranin A (CgA) and urinary 5 hydroxy-indoleacetic acid (5-HIAA) are used to aid staging and monitoring of patients with neuroendocrine (NET) tumors. Somatostatin analogues (SSA) such as octreotide and lanreotide have been used to alleviate symptoms and disease progression in NET patients. This study evaluates the use of CgA and 5HIAA in monitoring NET patients on SSA therapy at Newcastle NHS Foundation Trust.

Aim(s): Are appropriate baseline and follow-up measurements of CgA and 5HIAA being performed Trust-wide? Is there any difference between CgA and 5-HIAA tumour markers when used as a staging/monitoring tool in NET patients undergoing SSA therapy?

Materials and methods: All living and deceased patients with NETs who were on SSA therapy from 2004 up to November 2008 were obtained (n=90). Electronic and physical patient notes were used to obtain retrospective data of: 1.CgA and 5-HIAA levels before and after SSA therapy, 2. Type of SSA used and 3. Clinical outcomes-good or poor. Good outcomes defined by stable or improving symptoms, poor outcomes defined by deterioration in symptoms and increased morbidity/mortality as described in clinics. Simple descriptive statistics were used in evaluating whether patients had appropriate investigations before and after commencing SSA treatment. Microsoft Excel was used. Paired sample t-tests were used to establish whether there was a significant difference between CgA and 5-HIAA levels during SSA therapy. SPSS 6.01 statistical software was used.

Conference: 7th Annual ENETSConcerence (2010)

Presenting Author:

Authors: Teo L, Hearn K, Bernstone G, Wright R, Manus D,

Keywords: CgA, 5-HIAA, octreotide, lanreotide, prognosis, staging, neuroendocrine tumors,