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Prospective study of the ability of histamine, serotonin or serum chromogranin A levels to identify gastric carcinoids in patients with gastrinomas.

AbstractBACKGROUND:
Chronic hypergastrinaemia causes gastric enterochromaffin cell proliferation and carcinoid tumours. The only reliable means to diagnose enterochromaffin cell changes/carcinoids is by biopsy.
AIM:
To assess whether serum histamine, chromogranin A or serotonin and urinary N-methylimidazoleacetic acid or 5-hydroxyindoleacetic acid correlate with advanced enterochromaffin cell changes or gastric carcinoids in patients with gastrinomas.
METHODS:
Consecutive patients (n=145) had the above assays and endoscopy with gastric biopsies.
RESULTS:
Lower N-methylimidazoleacetic acid and chromogranin A levels (P < 0.0001) occurred in disease-free patients. In patients with active disease, the fasting serum gastrin levels correlated (P < 0.0001) with both chromogranin A and N-methylimidazoleacetic acid levels. Chromogranin A (P=0.005), but not N-methylimidazoleacetic acid, serotonin, 5-hydroxyindoleacetic acid or histamine levels, correlated with the enterochromaffin cell index. Carcinoids, but not advanced enterochromaffin cell changes only, were associated with higher chromogranin A and N-methylimidazoleacetic acid levels.
CONCLUSIONS:
Serum chromogranin A levels and urinary N-methylimidazoleacetic acid levels, but not serum histamine or serotonin or urinary 5-hydroxyindoleacetic acid, correlate with the presence of gastric carcinoids. However, no assay identified patients with advanced enterochromaffin cell changes only with high sensitivity/specificity. Thus, N-methylimidazoleacetic acid and chromogranin A levels are unable to identify patients with advanced changes in enterochromaffin cells and therefore neither can replace routine gastric biopsies.
AuthorsS Bashir, F Gibril, J V Ojeaburu, B Asgharian, L K Entsuah, G Ferraro, P Crafa, C Bordi, R T Jensen
JournalAlimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 16 Issue 7 Pg. 1367-82 (Jul 2002) ISSN: 0269-2813 [Print] England
PMID12144588 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Biomarkers, Tumor
  • CHGA protein, human
  • Chromogranin A
  • Chromogranins
  • Imidazoles
  • Neoplasm Proteins
  • methylimidazoleacetic acid
  • Serotonin
  • Hydroxyindoleacetic Acid
  • Histamine
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor (analysis, blood, urine)
  • Biopsy
  • Carcinoid Tumor (diagnosis, pathology)
  • Chromogranin A
  • Chromogranins (blood)
  • Female
  • Gastrinoma (blood, metabolism, urine)
  • Histamine (blood)
  • Humans
  • Hydroxyindoleacetic Acid (urine)
  • Imidazoles (urine)
  • Male
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 1 (blood, diagnosis, urine)
  • Neoplasm Proteins (blood)
  • Pancreatic Neoplasms (blood, metabolism, urine)
  • Prospective Studies
  • Sensitivity and Specificity
  • Serotonin (blood)
  • Stomach Neoplasms (diagnosis, pathology)
  • Zollinger-Ellison Syndrome (metabolism)

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