Association between neuroendocrine tumors biomarkers and primary tumor site and disease type based on total 68Ga-DOTATATE-Avid tumor volume measurements.

Abstract

OBJECTIVE:

To determine the association between neuroendocrine tumor (NET) biomarker levels and the extent of disease as assessed by 68Ga DOTATATE PET/CT imaging.

DESIGN:

A retrospective analysis of a prospective database of patients with NETs.

METHODS:

Fasting plasma chromogranin A (CgA), neuron-specific enolase (NSE), gastrin, glucagon, vasoactive intestinal peptide (VIP) and pancreatic polypeptide (PP), and 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) levels were measured. Correlation between biomarkers and total 68Ga-DOTATATE-avid tumor volume (TV) was analyzed.

RESULTS:

The analysis included 232 patients. In patients with pancreatic NETs (n = 112), 68Ga-DOTATATE TV correlated with CgA (r = 0.6, P = 0.001, Spearman). In patients with multiple endocrine neoplasia type 1 (n = 39), 68Ga-DOTATATE TV correlated with glucagon (r = 0.5, P = 0.01) and PP levels (r = 0.5, P = 0.049). In patients with von Hippel-Lindau (n = 24), plasma VIP (r = 0.5, P = 0.02) and PP levels (r = 0.7, P < 0.001) correlated with 68Ga-DOTATATE TV. In patients with small intestine NET (SINET, n = 74), 68Ga-DOTATATE TV correlated with CgA (r = 0.5, P = 0.02) and 5-HIAA levels (r = 0.7, P < 0.001), with 5-HIAA ≥8.1 mg/24 h associated with metastatic disease with high positive (81.8%) and negative (85.7%) predictive values (P = 0.001). 68Ga-DOTATATE TV in patients with NET of unknown primary (n = 16) and those with NET of other primary location (n = 30) correlated with 5-HIAA levels (r = 0.8, P = 0.002 and r = 0.7, P = 0.02 respectively).

CONCLUSIONS:

Our data supports the use of specific NET biomarkers based on the site of the primary NET and the presence of hereditary syndrome-associated NET. High urinary 5-HIAA levels indicate the presence of metastatic disease in patients with SINET.

• Authors: Amit Tirosh, Georgios Z Papadakis, Corina Millo, Samira M Sadowski, Peter Herscovitch, Karel Pacak, Stephen J Marx, Lily Yang, Pavel Nockel, Jasmine Shell, Patience Green, Xavier M Keutgen, Dhaval Patel, Naris Nilubol, Electron Kebebew
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 176 Issue 5 Pg. 575-582 (May 2017) ISSN: 1479-683X [Electronic] England
• PMID: 28289088 (Publication Type: Journal Article)
• Copyright: © 2017 European Society of Endocrinology.

Chemical References

• Biomarkers, Tumor
• Organometallic Compounds
• Radiopharmaceuticals
• Hydroxyindoleacetic Acid
• gallium Ga 68 dotatate

Topics

• Adult
• Biomarkers, Tumor (analysis, metabolism)
• Cohort Studies
• Databases, Factual
• Female
• Humans
• Hydroxyindoleacetic Acid (urine)
• Magnetic Resonance Imaging
• Male
• Multimodal Imaging
• Multiple Endocrine Neoplasia (diagnostic imaging, metabolism)
• Neoplasm Metastasis
• Neuroendocrine Tumors (diagnostic imaging, metabolism)
• Organometallic Compounds
• Pancreatic Neoplasms (diagnostic imaging, metabolism)
• Positron-Emission Tomography
• Radiopharmaceuticals
• Retrospective Studies