Nanno Yoshihide, Toyama Hirochika, Matsumoto Ippei, Otani Kyoko, Asari Sadaki, Goto Tadahiro, Ajiki Tetsuo, Zen Yoh, Fukumoto Takumi, Ku Yonson
Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Pancreatology. 2017 Mar-Apr;17(2):291-294. doi: 10.1016/j.pan.2016.12.012. Epub 2016 Dec 29.
The present study aimed to elucidate prognostic values of baseline plasma chromogranin A (CgA) concentrations in patients with resectable, well-differentiated pancreatic neuroendocrine tumors (PNETs).
Preoperative CgA levels in 21 patients with PNET were correlated with clinicopathological factors and patients' survival.
Plasma CgA levels ranged 2.9-30.8 pmol/mL (median 6.0), and were significantly elevated in patients with post-operative recurrence (P = 0.004). Using the receiver operating characteristic curve, the optimal cutoff value to predict tumor recurrence was determined as 17.0 pmol/mL. This threshold identified patients with recurrence with 60% sensitivity, 100% specificity, and 90% overall accuracy. Patients with higher CgA levels showed worse recurrence-free survival than those with low CgA levels, both in total (P < 0.001) and in G2 patients (P = 0.020).
Combined plasma CgA concentrations and WHO grading may assist in better stratification of PNET patients in terms of the risk of recurrence.
本研究旨在阐明基线血浆嗜铬粒蛋白A（CgA）浓度在可切除的高分化胰腺神经内分泌肿瘤（PNET）患者中的预后价值。
对21例PNET患者术前的CgA水平与临床病理因素及患者生存率进行相关性分析。
血浆CgA水平范围为2.9 - 30.8 pmol/mL（中位数为6.0），术后复发患者的血浆CgA水平显著升高（P = 0.004）。通过绘制受试者工作特征曲线，确定预测肿瘤复发的最佳临界值为17.0 pmol/mL。该阈值识别复发患者的灵敏度为60%，特异度为100%，总体准确率为90%。CgA水平较高的患者无论总体（P < 0.001）还是G2期患者（P = 0.020），其无复发生存率均低于CgA水平较低的患者。
联合血浆CgA浓度和世界卫生组织分级可能有助于根据复发风险对PNET患者进行更好的分层。
