Kim Moonjin, Lee Sujin, Lee Jeeyun, Park Se Hoon, Park Joon Oh, Park Young Suk, Kang Won Ki, Kim Seung Tae
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea ; Gastrointestinal Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2016 Jan;48(1):153-61. doi: 10.4143/crt.2014.183. Epub 2015 Mar 7.
Chromogranin A (CgA) has been considered to be valuable not only in the diagnosis but also in monitoring the disease response to treatment. However, only a few studies have been published on this issue. We purposed to evaluate whether biochemical response using plasma CgA level is reliable in concordance with the clinical response of grade 1-3 nonfunctiong gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
Between March 2011 and September 2013, a total of 27 cases in 18 patients were analysed, clinically and radiologically while serial CgA tests were also conducted during treatment. Tumor responses were defined by both Response Evaluation Criteria in Solid Tumors (RECIST) criteria ver. 1.1 and biochemical criteria based on the CgA level.
Among the 27 cases analysed, no difference in the basal CgA level was observed with regard to gender, primary tumor site, tumor grade (World Health Organization classification), liver metastasis, number of metastatic site, and line of chemotherapy. The overall response rate (RR) by RECIST criteria ver. 1.1 was six out of the 27 cases (22.2%) and eight out of the 27 cases (29.6%) for biochemical RR. The overall concordance rates of the response based on RECIST and biochemical criteria were 74%. In grades 1 and 2 GEP-NETs (n=17), the concordance rate of the disease control was 94.1%. There was a significant difference for progression-free survival (PFS) between responders and non-responder in accordance to biochemical criteria (35.73 months vs. 5.93 months, p=0.05).
This study revealed that changes of the plasma CgA levels were associated with tumour response. Additionally, biochemical response based on serial CgA may be a predictive marker for PFS in GEP-NETs.
嗜铬粒蛋白A（CgA）不仅被认为在诊断中具有价值，而且在监测疾病对治疗的反应方面也有价值。然而，关于这个问题仅有少数研究发表。我们旨在评估使用血浆CgA水平的生化反应与1-3级无功能胃肠胰神经内分泌肿瘤（GEP-NETs）的临床反应是否一致。
2011年3月至2013年9月期间，对18例患者中的27例病例进行了临床和放射学分析，同时在治疗期间也进行了系列CgA检测。肿瘤反应根据实体瘤疗效评价标准（RECIST）1.1版标准以及基于CgA水平的生化标准来定义。
在分析的27例病例中，在性别、原发肿瘤部位、肿瘤分级（世界卫生组织分类）、肝转移、转移部位数量和化疗线数方面，未观察到基础CgA水平有差异。根据RECIST 1.1版标准的总缓解率（RR）为27例中的6例（22.2%），生化RR为27例中的8例（29.6%）。基于RECIST和生化标准的反应总体一致率为74%。在1级和2级GEP-NETs（n = 17）中，疾病控制的一致率为94.1%。根据生化标准，反应者和无反应者之间的无进展生存期（PFS）有显著差异（35.73个月对5.93个月，p = 0.05）。
本研究表明血浆CgA水平的变化与肿瘤反应相关。此外，基于系列CgA的生化反应可能是GEP-NETs中PFS的预测标志物。
