Improved diagnostic accuracy for neuroendocrine neoplasms using two chromogranin A assays
- 23 April 2012
- journal article
- research article
- Published by Wiley in Clinical Endocrinology
- Vol. 76 (6), 831-836
- https://doi.org/10.1111/j.1365-2265.2011.04319.x
Abstract
Context Chromogranin A (Cg A) is the best available diagnostic marker for neuroendocrine neoplasms (NENs). However, clinical interpretation of Cg A results may be limited by considerable heterogeneity between commonly available Cg A assays. Variation in diagnostic accuracy of these assays largely reflects differences in antibody specificities. We compared the diagnostic utility of four Cg A assays [Imperial Supra-regional Assay Service radioimmunoassay (SAS) and three commercial assays, Cisbio, DAKO and Eurodiagnostica]. Method Plasma Cg A was measured using these four assays in 125 patients with NENs, 41 patients with cancers other than NENs and 108 healthy controls. Result There was no significant difference in diagnostic accuracy between any of the four assays alone and no single assay positively identified all patients with NEN. However, concordance between assays was variable. Cisbio and SAS assays were least concordant. We, therefore, hypothesized that using a combination of the least concordant Cg A assays will improve NEN diagnosis by detecting a larger number of Cg A epitopes and hence patients with NEN. Consistent with our hypothesis, multiple logistic regression analysis showed that the combination of Cisbio and SAS assays was more useful than any other combinations or any assay alone in predicting a NEN diagnosis. Conclusion Although individually, all four Cg A assays are similarly useful for the measurement of Cg A in the diagnosis of a NEN, in patients with a suspected NEN, negative results by one assay should prompt analysis by a second assay. The combination of Cisbio and SAS assays may have greatest diagnostic utility.Keywords
This publication has 24 references indexed in Scilit:
- Immunohistochemical and Biochemical Studies with Region-Specific Antibodies to Chromogranins A and B and Secretogranins II and III in Neuroendocrine TumorsCellular and Molecular Neurobiology, 2010
- Chromogranin A: A new proposal for trafficking, processing and induction of granule biogenesisRegulatory Peptides, 2010
- ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Biochemical MarkersNeuroendocrinology, 2009
- Chromogranin A levels in chronic liver disease and hepatocellular carcinomaDigestive and Liver Disease, 2009
- Elevated Cocaine- and Amphetamine-Regulated Transcript Immunoreactivity in the Circulation of Patients with Neuroendocrine MalignancyJournal of Clinical Endocrinology & Metabolism, 2008
- Chromogranin A and pancreastatin-like immunoreactivity in normal pregnanciesJournal of Clinical Endocrinology & Metabolism, 1996
- Chromogranin positive cells in colorectal carcinoma and transitional mucosa.Journal of Clinical Pathology, 1995
- Glucocorticoid activation of chromogranin A gene expression. Identification and characterization of a novel glucocorticoid response element.JCI Insight, 1994
- Chromogranin A in uremia: Progressive retention of immunoreactive fragmentsKidney International, 1990
- Secretion of a Chromaffin Granule Protein, Chromogranin, from the Adrenal Gland after Splanchnic StimulationNature, 1967