Woltering Eugene A, Hilton Ruth S, Zolfoghary Christy M, Thomson Jessica, Zietz Stanley, Go Vay Liang W, Vinik Aaron I, Vinik Etta, O'Dorisio Thomas M, Mamikunian Gregg
Section of Surgical Endocrinology, Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Pancreas. 2006 Oct;33(3):250-4. doi: 10.1097/01.mpa.0000235302.73615.d4.
Chromogranin A (CGA) levels are used to confirm the diagnosis and monitor the course of patients with neuroendocrine tumors. Chromogranin A levels are significantly reduced when patients are acutely treated with octreotide; however, limited data are available that correlates octreotide long-acting repeatable (LAR) dose or steady state octreotide blood levels to the absolute value of serum or plasma CGA.
Plasma, serum, and clinical information on carcinoid syndrome symptoms were collected anonymously from 40 patients treated with long-term octreotide LAR therapy for carcinoid syndrome.
We found a strong positive linear relationship exists between serum and plasma CGA levels (r = 0.9858, P < 0.0001). No correlation existed between plasma octreotide levels or LAR dose and the static, absolute plasma/serum CGA levels. Although, higher mean CGA values were seen in the group whose diarrhea was "not under optimal control" than for the group "under optimal control," these results did not reach statistical significance (P = 0.24). Contrary to our hypotheses, a statistically significant inverse relationship was found between the frequency of flushing and the CGA levels (P = 0.0372). Higher mean CGA values were observed in the "under optimal control" group with flushing symptoms.
Either serum or plasma can be used to measure CGA levels. Absolute (static) CGA levels do not positively correlate with symptom intensity during LAR therapy. Dynamic (serial) measurements of CGA are necessary to monitor the effectiveness of medical or surgical therapy.
嗜铬粒蛋白A（CGA）水平用于确诊和监测神经内分泌肿瘤患者的病程。当患者接受奥曲肽急性治疗时，嗜铬粒蛋白A水平会显著降低；然而，关于奥曲肽长效重复注射（LAR）剂量或奥曲肽稳态血药浓度与血清或血浆CGA绝对值之间相关性的数据有限。
从40例接受长期奥曲肽LAR治疗类癌综合征的患者中匿名收集血浆、血清及类癌综合征症状的临床信息。
我们发现血清和血浆CGA水平之间存在强正线性关系（r = 0.9858，P < 0.0001）。血浆奥曲肽水平或LAR剂量与静态、绝对血浆/血清CGA水平之间不存在相关性。虽然，“腹泻未得到最佳控制”组的平均CGA值高于“得到最佳控制”组，但这些结果未达到统计学显著性（P = 0.24）。与我们的假设相反，发现潮红频率与CGA水平之间存在统计学显著的负相关（P = 0.0372）。在有潮红症状的“得到最佳控制”组中观察到较高的平均CGA值。
血清或血浆均可用于测量CGA水平。在LAR治疗期间，绝对（静态）CGA水平与症状强度无正相关。动态（系列）测量CGA对于监测药物或手术治疗的有效性是必要的。
