Department of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland.
The Cardinal Stefan Wyszyński National Institute of Cardiology, 04-628 Warsaw, Poland.
Med Clin (Barc). 2022 Jul 22;159(2):85-89. doi: 10.1016/j.medcli.2021.06.029. Epub 2021 Nov 1.
Progression of carcinoid syndrome (CS) to carcinoid heart disease (CHD) is difficult to predict. This retrospective analysis evaluates the use of chromogranin A (CgA), a biomarker widely used in the diagnosis of neuroendocrine tumours (NET), in monitoring CS and disease progression.
108 patients with confirmed CS, selected from a group of 351 patients with neuroendocrine neoplasms of the small intestine (SI-NENs), including NETG1 well 40% and NETG2 60% moderately differentiated NET. CgA concentration was measured during initial diagnosis and clinical follow up in 84 patients, 27 of them subsequently developed CHD. The patient's overall survival (OS) was evaluated using the Kaplan-Meier method.
Patients with CHD, were found to have significantly shorter OS than patients with CS but without CHD (67.22 vs. 73.03 months). Univariate and multivariate analyses revealed that initial high concentration of CgA and/or increased concentration of CgA is significantly associated with decreased median OS in patients with CS (p<0.05).
CgA has potential as a clinically useful biomarker in reporting disease status and predicting outcome in patients with CS and with CHD.
类癌综合征（CS）进展为类癌性心脏病（CHD）较难预测。本回顾性分析评估了嗜铬粒蛋白 A（CgA）在 CS 监测和疾病进展中的应用，CgA 是一种广泛用于诊断神经内分泌肿瘤（NET）的生物标志物。
从一组 351 例小肠神经内分泌肿瘤（SI-NENs）患者中选择了 108 例确诊 CS 的患者，其中 NETG1 为 40%，NETG2 为 60%为中分化 NET。84 例患者在初始诊断和临床随访期间测量了 CgA 浓度，其中 27 例随后发生 CHD。采用 Kaplan-Meier 法评估患者的总生存期（OS）。
CHD 患者的 OS 明显短于 CS 但无 CHD 的患者（67.22 与 73.03 个月）。单因素和多因素分析表明，初始 CgA 浓度高和/或 CgA 浓度升高与 CS 患者的中位 OS 降低显著相关（p<0.05）。
CgA 可能是一种有用的临床生物标志物，可用于报告 CS 患者的疾病状态并预测伴有 CHD 的患者的结局。
