The role of chromogranin A in the management of patients with phaeochromocytoma
The role of chromogranin A in the management of patients with phaeochromocytoma
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DOI：
10.1111/j.1365-2265.2006.02591.x
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发表时间：
2006-09-01
影响因子：
3.2
通讯作者：
Loli, Paola
中科院分区：
文献类型：
--
作者：
Grossrubatscher, Erika;Dalino, Paolo;Loli, Paola
目的 嗜铬粒蛋白 A (CgA) 是神经内分泌肿瘤最准确的通用标志物。在神经外胚层来源的肿瘤（如嗜铬细胞瘤和副神经节瘤）患者中，记录了超正常的 CgA 浓度。设计本研究的目的是与尿儿茶酚胺及其代谢物相比，评估 CgA 测定在治疗嗜铬细胞瘤患者中的作用。患者研究的患者包括 22 例初发或手术治愈后数年复发或随访期间患有嗜铬细胞瘤的患者。恶性嗜铬细胞瘤。在手术切除嗜铬细胞瘤之前和之后对 17 名患者进行了评估。为了评估激素参数的特异性，招募了 20 名受试者作为对照；他们来自一组因疑似嗜铬细胞瘤而接受我们观察的患者，随后被证明没有患有该病。 结果 82% 和 77% 的患者尿肾上腺素和去甲肾上腺素超正常。 84% 和 89% 的患者尿变肾上腺素和去甲变肾上腺素分别超正常。尿变肾上腺素和去甲变肾上腺素的组合在识别嗜铬细胞瘤方面的敏感性为 100%。 91% 的患者 CgA 超正常。结合CgA和尿儿茶酚胺（肾上腺素和去甲肾上腺素）的结果，诊断嗜铬细胞瘤的敏感性为100%。恶性嗜铬细胞瘤患者的尿儿茶酚胺、代谢物（变肾上腺素和去甲变肾上腺素）和CgA水平与良性病变患者没有显着差异。在大多数情况下，CgA 在手术后恢复正常。结论我们的结果表明，CgA 是嗜铬细胞瘤的良好标志物； CgA 的测量可能在嗜铬细胞瘤手术患者的随访中发挥作用。
Objective Chromogranin A (CgA) is the most accurate general marker of neuroendocrine tumours. Supranormal CgA concentrations have been recorded in patients with tumours of neuroectodermal origin such as phaeochromocytoma and paraganglioma.Design The present study was performed to assess the role of CgA determination in the management of patients with phaeochromocytoma, in comparison with urinary catecholamines and their metabolites.Patients The patients studied included 22 cases with phaeochromocytoma at initial presentation or at relapse some years after surgical cure or during follow-up of a malignant phaeochromocytoma. Seventeen patients were evaluated before and after surgical removal of phaeochromocytoma. To assess the specificity of the hormonal parameters, 20 subjects were enrolled as controls; they were from a group of patients referred to our observation for possible phaeochromocytoma and who were subsequently proven not to have the disease.Results Urinary epinephrine and norepinephrine were supranormal in 82% and 77% of patients, respectively. Urinary metanephrines and normetanephrines were supranormal in 84% and 89% of patients, respectively. The combination of urinary metanephrine and normetanephrine had a sensitivity of 100% in identifying a phaeochromocytoma. CgA was supranormal in 91% of patients. Combining the results of CgA and urinary catecholamines (epinephrine and norepinephrine), the sensitivity for diagnosis of phaeochromocytoma was 100%. Urinary catecholamines, metabolites (metanephrine and normetanephrine) and CgA levels in patients with malignant phaeochromocytoma did not differ significantly from those of patients with benign lesions. In most cases, CgA normalized after surgery.Conclusions Our results indicate that CgA is a good marker of phaeochromocytoma; measurement of CgA could have a role in the follow-up of patients operated on for phaeochromocytoma.