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Chromogranin-A and N-terminal pro-brain natriuretic peptide: an excellent pair of biomarkers for diagnostics in patients with neuroendocrine tumor.

AbstractPURPOSE:
For the last decade chromogranin-A (CgA) has been a well-established marker for neuroendocrine tumor (NET), and N-terminal pro-brain natriuretic peptide (NT-proBNP) has been a useful marker for left ventricular dysfunction. This study examined the diagnostic value of CgA and NT-proBNP for carcinoid heart disease (CHD), and their prognostic value for overall survival in NET patients.
PATIENTS AND METHODS:
Serum samples were obtained and cardiac ultrasound studies performed in 102 NET patients. The criterion for mild and severe CHD was tricuspid regurgitation stage I/II and III/IV, respectively. Proportional odds and Cox proportional hazards models were constructed respectively to identify the association between CHD and overall survival with patient characteristics and the two markers.
RESULTS:
Severe CHD was found in 15 (15%) of 102 patients, 13 of whom had elevated NT-proBNP levels. In the univariate proportional odds model CHD was correlated with age (P = .007), CgA (P = .002), and NT-proBNP (P < .001), whereas in the multivariate model NT-proBNP and CgA were significantly associated with CHD (P < .001 and P = .01). In the univariate Cox models, age (P = .04), sex (P = .03), CgA (P = .003), and NT-proBNP (P = .04) were related to overall survival, and in the multivariate model CgA and NT-proBNP remained significantly related to overall survival (P = .002 and P = .04, respectively).
CONCLUSION:
NT-proBNP and CgA are very important markers in the diagnosis of CHD in patients with NET. Furthermore, patients with elevated NT-proBNP in addition to elevated CgA levels showed worse overall survival than patients with elevated CgA alone.
AuthorsCatharina M Korse, Babs G Taal, Cornelis A de Groot, Robert H Bakker, Johannes M G Bonfrer
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 27 Issue 26 Pg. 4293-9 (Sep 10 2009) ISSN: 1527-7755 [Electronic] United States
PMID19667278 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
  • Chromogranin A
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
Topics
  • Aged
  • Biomarkers (blood)
  • Carcinoid Heart Disease (blood, diagnosis)
  • Chromogranin A (blood)
  • Female
  • Humans
  • Immunoradiometric Assay (statistics & numerical data)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Natriuretic Peptide, Brain (blood)
  • Neuroendocrine Tumors (blood, diagnosis)
  • Peptide Fragments (blood)
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Sensitivity and Specificity
  • Survival Analysis

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