Korse Catharina M, Bonfrer Johannes M G, Aaronson Neil K, Hart Augustinus A M, Taal Babs G
Department of Clinical Chemistry, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Neuroendocrinology. 2009;89(3):296-301. doi: 10.1159/000162876. Epub 2008 Oct 7.
Urinary 5-HIAA excretion is a well-known marker in neuroendocrine tumors (NETs), but it has a low sensitivity and the 24-hour collection is inconvenient for patients. Chromogranin A (CgA) is a promising marker, but a thorough evaluation during follow-up is still lacking.
39 patients with metastatic gastrointestinal NETs were monitored during treatment with the long-acting octreotide SandostatinLAR. A comparison was made between serum CgA and urinary 5-HIAA in relation to quality of life (HRQL) assessed by the EORTC QLQ-C30 questionnaire, supplemented with questions specific to carcinoid symptoms. Survival analyses were performed to examine the association between the markers and survival time.
Correlations were found between CgA and physical functioning (p = 0.01) and quality of life (p = 0.03), while no significant correlations were observed between 5-HIAA levels and any of the self-reported health outcomes. Cox regression showed an association between CgA levels and survival time (p = 0.02), while no significant association was observed between 5-HIAA levels and survival time.
Stronger correlations of CgA compared to 5-HIAA with physical functioning and wellbeing, the convenience of measuring in blood, as well as the prognostic value of CgA for survival, makes CgA the recommended marker in the management of patients with metastatic NETs.
尿5-羟吲哚乙酸（5-HIAA）排泄是神经内分泌肿瘤（NETs）中一种广为人知的标志物，但它敏感性较低，且24小时尿液收集对患者来说不方便。嗜铬粒蛋白A（CgA）是一种有前景的标志物，但在随访期间仍缺乏全面评估。
39例转移性胃肠道NETs患者在接受长效奥曲肽善龙治疗期间接受监测。比较血清CgA和尿5-HIAA与通过欧洲癌症研究与治疗组织QLQ-C30问卷评估的生活质量（HRQL）之间的关系，并补充了类癌症状特异性问题。进行生存分析以检验这些标志物与生存时间之间的关联。
发现CgA与身体功能（p = 0.01）和生活质量（p = 0.03）之间存在相关性，而未观察到5-HIAA水平与任何自我报告的健康结果之间存在显著相关性。Cox回归显示CgA水平与生存时间之间存在关联（p = 0.02），而未观察到5-HIAA水平与生存时间之间存在显著关联。
与5-HIAA相比，CgA与身体功能和幸福感的相关性更强，血液检测的便利性以及CgA对生存的预后价值，使得CgA成为转移性NETs患者管理中的推荐标志物。
