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

Kruljac, Ivan and Vurnek, Ivan and Maasberg, Sebastian and Kust, Davor and Blaslov, Kristina and Ladika Davidović, Blaženka and Štefanović, Mario and Demirović, Alma and Bišćanin, Alen and Filipović-Čugura, Jakša and Marić Brozić, Jasmina and Pape, Ulrich-Frank and Vrkljan, Milan (2018) A score derived from routine biochemical parameters increases the diagnostic accuracy of chromogranin A in detecting patients with neuroendocrine neoplasms. Endocrine, 60 (3). pp. 395-406. ISSN 1355-008X

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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.

Item Type: Article
MeSH: Adult ; Aged ; Biomarkers, Tumor/blood ; Chromogranin A/blood ; Female ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors/blood ; Neuroendocrine Tumors/diagnosis ; Pancreatic Neoplasms/blood ; Pancreatic Neoplasms/diagnosis ; Retrospective Studies ; Sensitivity and Specificity
Departments: Katedra za internu medicinu
Depositing User: Kristina Berketa
Status: Published
Maasberg, SebastianUNSPECIFIED
Blaslov, KristinaUNSPECIFIED
Ladika Davidović, BlaženkaUNSPECIFIED
Štefanović, MarioUNSPECIFIED
Demirović, AlmaUNSPECIFIED
Filipović-Čugura, JakšaUNSPECIFIED
Marić Brozić, JasminaUNSPECIFIED
Pape, Ulrich-FrankUNSPECIFIED
Date: June 2018
Date Deposited: 26 Sep 2019 09:07
Last Modified: 26 Aug 2020 07:45
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/3395

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