Lecoeur Antoine, Sfeir Rita-Maria, Gerard Laura, Souifi Myriam, Damour Johanna, Lombard-Bohas Catherine, Francois Laurent, Fort Justine, Delsart Daphne, Forestier Julien, Walter Thomas, Durand Alice, Chardon Laurence
Service d'Oncologie Médicale, Hospices Civils de Lyon, Centre d'Excellence ENETS, Lyon 69003, France.
Service de Biochimie et biologie moléculaire, Hospices Civils de Lyon, Bron 69500, France.
Eur J Endocrinol. 2024 Nov 27;191(6):570-578. doi: 10.1093/ejendo/lvae150.
The aim of this study was to evaluate the performance of different biomarkers for the detection of carcinoid heart disease (CHD) in neuroendocrine tumours (NETs), in particular serum 5-HIAA (s5HIAA).
An explorative ancillary study of the French CrusoeNET cohort.
Patients managed in the Lyon-EURACAN Center of Excellence (CoE) were included when they were aged of at least 18 years, treated and followed for an advanced/metastatic ileum or lung NET, a NET irrespective of the primary location or from unknown primary location but with clinical CS, and/or elevation of urinary 5-HIAA (u5HIAA) twice greater than the upper limit of normal. All patients included had 1 available serum stored within the local biobank between January 2021 and April 2022. Echocardiography was performed by 1 of the 3 expert cardiologists of the Lyon-EURACAN-CoE.
We included 138 patients with NETs, mainly of the small intestine and lung, and 19 of them had a CHD. Analysis showed that s5HIAA was well correlated with u5HIAA (ρ = 0.824 [0.76-0.88], P < .0001) and was a good biomarker for CHD detection (receiver operating characteristic curve = 0.85 [0.75-0.94], P < .0001). Using a threshold value of 757 nmol/L, the sensitivity and specificity for the detection of CHD were 84% and 80%, respectively.
s5HIAA is highly sensitive and specific for CHD detection. It could be used as a pre-screening tool in centres where systematic and regular echocardiography by an expert cardiologist is not performed in this population.
本研究旨在评估不同生物标志物在检测神经内分泌肿瘤（NETs）中类癌性心脏病（CHD）的性能，特别是血清5-羟吲哚乙酸（s5HIAA）。
对法国CrusoeNET队列进行的探索性辅助研究。
纳入里昂-EURACAN卓越中心（CoE）管理的患者，这些患者年龄至少18岁，因晚期/转移性回肠或肺NET接受治疗和随访，NET不论原发部位或原发部位不明但有临床类癌综合征（CS），和/或尿5-羟吲哚乙酸（u5HIAA）升高两倍以上高于正常上限。所有纳入患者在2021年1月至2022年4月期间在当地生物样本库中有1份可用血清。超声心动图由里昂-EURACAN-CoE的3名专家心脏病学家之一进行。
我们纳入了138例NET患者，主要来自小肠和肺，其中19例患有CHD。分析表明，s5HIAA与u5HIAA相关性良好（ρ = 0.824 [0.76 - 0.88]，P <.0001），是检测CHD的良好生物标志物（受试者操作特征曲线 = 0.85 [0.75 - 0.94]，P <.0001）。使用757 nmol/L的阈值，检测CHD的敏感性和特异性分别为84%和80%。
s5HIAA对CHD检测具有高度敏感性和特异性。在该人群中未由专家心脏病学家进行系统定期超声心动图检查的中心，它可作为一种预筛查工具。
