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A score derived from routine biochemical parameters increases the diagnostic accuracy of chromogranin A in detecting patients with neuroendocrine neoplasms

  • Endocrine Methods and Techniques
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Abstract

Background

Chromogranin A (CgA) is a valuable biomarker for detection and follow-up of patients with neuroendocrine neoplasms (NENs). However, various comorbidities may influence serum CgA, which decreases its diagnostic accuracy. We aimed to investigate which laboratory parameters are independently associated with increased CgA in real-life setting and to develop a scoring system, which could improve the diagnostic accuracy of CgA in detecting patients with NENs.

Methods

This retrospective study included 55 treatment naïve patients with NENs and160 patients with various comorbidities but without NEN (nonNENs). Scoring system (CgA-score) was developed based on z-scores obtained from receiver operating curve analysis for each parameter that was associated with elevated serum CgA in nonNENs.

Results

CgA correlated positively with serum BUN, creatinine, α2-globulin, red-cell distribution width, erythrocyte sedimentation rate, plasma glucose and correlated inversely with hemoglobin, thrombocytes and serum albumin. Serum CgA was also associated with the presence of chronic renal failure, arterial hypertension and diabetes and the use of PPI. In the entire study population, CgA showed an area under the curve of 0.656. Aforementioned parameters were used to develop a CgA-score. In a cohort of patients with CgA-score <12.0 (N = 87), serum CgA >156.5 ng/ml had 77.8% sensitivity and 91.5% specificity for detecting NENs (AUC 0.841, 95% CI 0.713–0.969, P < 0.001). Serum CgA had no diagnostic value in detecting NENs in patients with CgA-score >12.0 (AUC 0.554, 95% CI 0.405–0.702, P = 0.430).

Conclusions

CgA-score encompasses a wide range of comorbidities and represents a promising tool that could improve diagnostic performance of CgA in everyday clinical practice.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb School of Medicine, Zagreb, Croatia

    Ivan Kruljac, Kristina Blaslov & Milan Vrkljan

  2. University of Zagreb School of Medicine, Zagreb, Croatia

    Ivan Vurnek

  3. Department of Hepatology and Gastroenterology, ENETS Center of Excellence for Neuroendocrine Tumors, Charité Campus Mitte and Virchow Clinic, Charité University Medicine, Berlin, Germany

    Sebastian Maasberg & Ulrich-Frank Pape

  4. Department of Oncology and Nuclear Medicine, University Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia

    Davor Kust, Blaženka Ladika Davidović & Jasmina Marić Brozić

  5. Clinical Institute of Chemistry, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia

    Mario Štefanović

  6. Department of Pathology, University Hospital Center “Sestre Milosrdnice”, University of Zagreb School of Medicine, Zagreb, Croatia

    Alma Demirović

  7. Department of Gastroenterology and Hepatology, University Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia

    Alen Bišćanin

  8. Department of Surgery, University Hospital Center “Sestre Milosrdnice”, Zagreb, Croatia

    Jakša Filipović-Čugura

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  1. Ivan Kruljac
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Correspondence to Ivan Kruljac.

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Previous presentations of this work: This work has been presented in a form of poster presentation at 14th Annual ENETS Conference, March 2017, Barcelona, Spain.

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Kruljac, I., Vurnek, I., Maasberg, S. et al. A score derived from routine biochemical parameters increases the diagnostic accuracy of chromogranin A in detecting patients with neuroendocrine neoplasms. Endocrine 60, 395–406 (2018). https://doi.org/10.1007/s12020-018-1592-6

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  • DOI: https://doi.org/10.1007/s12020-018-1592-6

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