The role of the acute octreotide suppression test in detecting patients with neuroendocrine neoplasms

Kruljac, Ivan and Vičić, Ivan and Blaslov, Kristina and Kolak, Zorica and Benković, Martina and Kust, Davor and Ladika Davidović, Blaženka and Tometić, Gordan and Penavić, Ivan and Dabelić, Nina and Vazdar, Ljubica and Pavić, Tajana and Vrkljan, Milan (2018) The role of the acute octreotide suppression test in detecting patients with neuroendocrine neoplasms. Neuroendocrinology, 107 (3). pp. 284-291. ISSN 0028-3835

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Background: Serum chromogranin A (CgA) is routinely used as a biomarker in patients with neuroendocrine neoplasms (NENs). Several conditions and comorbidities may be associated with falsely elevated CgA, often leading to extensive diagnostic evaluation, which may be costly and harmful. The aim of this study was to analyze the effectiveness of the acute octreotide suppression test (AOST) in differentiating falsely elevated serum CgA. ----- Methods: Our prospective study enrolled 45 patients from two different patient cohorts: (1) 29 patients with suspicion or presence of NENs (extensive workup and subsequent biopsy confirmed 16 NENs); (2) 16 consecutive patients admitted via the Emergency Department without NENs (non-NENs). AOST was performed after an overnight fast. Baseline CgA was measured, after which 0.25 mg of octreotide was administered subcutaneously. CgA was measured 3 and 6 h after administration. ----- Results: Baseline CgA levels were similar in NENs and non-NENs. At the end of the AOST, CgA decreased by a median of 83.3% (41.0-127.4) in non-NENs and 13.8% (0.0-43.6) in NENs (p < 0.001). In patients with increased baseline CgA, a decrease in CgA at the 6th hour of < 51.3% had 90.0% sensitivity and 88.9% specificity in detecting NENs. In patients with normal baseline serum CgA, a decrease in CgA at the 3rd hour of < 17.6% had 83.3% sensitivity and 81.8% specificity in detecting patients with NENs. The diagnostic accuracy of the AOST in the entire study population was 86.7%. ----- Conclusions: AOST is a promising tool to increase the diagnostic accuracy of serum CgA.

Item Type: Article
MeSH: Aged ; Biomarkers, Tumor / blood ; Chromogranin A / blood ; Female ; Humans ; Intestinal Neoplasms / blood ; Intestinal Neoplasms / diagnosis ; Male ; Middle Aged ; Neuroendocrine Tumors / blood ; Neuroendocrine Tumors / diagnosis ; Octreotide ; Pancreatic Neoplasms / blood ; Pancreatic Neoplasms / diagnosis ; Prospective Studies ; Sensitivity and Specificity
Departments: Katedra za internu medicinu
Depositing User: Kristina Berketa
Status: Published
Blaslov, KristinaUNSPECIFIED
Benković, MartinaUNSPECIFIED
Ladika Davidović, BlaženkaUNSPECIFIED
Tometić, GordanUNSPECIFIED
Vazdar, LjubicaUNSPECIFIED
Date: 2018
Date Deposited: 07 Jan 2020 12:38
Last Modified: 07 Jan 2020 12:38
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