SECRETION OF CHROMOGRANIN-A BY PEPTIDE-PRODUCING ENDOCRINE NEOPLASMS
SECRETION OF CHROMOGRANIN-A BY PEPTIDE-PRODUCING ENDOCRINE NEOPLASMS
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DOI：
10.1056/nejm198605013141803
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发表时间：
1986-05-01
影响因子：
158.5
通讯作者：
DEFTOS, LJ
中科院分区：
文献类型：
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作者：
OCONNOR, DT;DEFTOS, LJ
嗜铬粒蛋白A是一种与儿茶酚胺从肾上腺髓质中共同储存和释放的蛋白质，最近在多种人体内分泌组织中被发现，包括正常和肿瘤组织。在以下肿瘤疾病患者的研究中，我们研究了肽激素产生的人类肿瘤分泌的嗜铬细胞瘤、甲状旁腺瘤、原发性甲状旁腺增生、甲状腺髓样癌、甲状腺c细胞增生、类癌、燕麦细胞肺癌、胰岛细胞肿瘤和主动脉体肿瘤。所有这些患者组血浆嗜铬粒蛋白A浓度均升高。我们使用凝胶过滤法根据大小区分不同形式的免疫反应性血浆嗜铬粒蛋白A。血浆嗜铬粒蛋白A水平在不同“控制”条件下（良性和恶性，内分泌和非内分泌）均未升高，其中肽激素不产生。血浆嗜铬粒蛋白A升高诊断产生肽的内分泌肿瘤的敏感性和特异性分别为81%和100%。血浆嗜铬粒蛋白A的升高表明，这些肿瘤与肿瘤通常的常驻激素一起释放嗜铬粒蛋白A，这些肿瘤可能被定性为“嗜铬粒瘤”，血浆嗜铬粒蛋白A的测量可能是内分泌肿瘤，特别是多发性内分泌肿瘤患者的有用诊断方法。
Chromogranin A, the protein that is co-stored and co-released with catecholamines from the adrenal medulla, has recently been identified in a variety of human endocrine tissues, both normal and neoplastic. We investigated the secretion of chromogranin A by peptide hormone-producing human tumors in studies of patients with the following neoplastic disorders: pheochromocytoma, parathyroid adenoma, primary parathyroid hyperplasia, medullary thyroid carcinoma, thyroidal C-cell hyperplasia, carcinoid tumor, oat-cell lung carcinoma, pancreatic islet-cell tumor, and aortic-body tumor. All these patient groups had elevated concentrations of plasma chromogranin A. We distinguished different forms of immunoreactive plasma chromogranin A by size with the use of gel filtration. Plasma chromogranin A levels were not elevated in patients with diverse "control" conditions - both benign and malignant and both endocrine and nonendocrine - in which peptide hormones are not produced. The sensitivity and specificity of plasma chromogranin A elevations in the diagnosis of peptide-producing endocrine neoplasms were 81 and 100 percent, respectively. The elevation of plasma chromogranin A in our subjects suggests that their neoplasms co-release chromogranin A along with the usual resident hormone of the tumor, that these neoplasms could be characterized as "chromograninomas," and that measurement of plasma chromogranin A may be a useful diagnostic procedure in subjects with endocrine tumors, especially multiple endocrine neoplasia.