Regular Article

British Journal of Cancer (2001) 84, 636–642. doi:10.1054/bjoc.2000.1659 www.bjcancer.com
Published online 27 February 2001

A new human chromogranin 'A' immunoradiometric assay for the diagnosis of neuroendocrine tumours

G P Bernini1, A Moretti1, M Ferdeghini2, S Ricci2, C Letizia3, E D'Erasmo3, G F Argenio1 and A Salvetti1

  1. 1Department of Internal Medicine, University of Pisa, Pisa, Italy
  2. 2Department of Oncology, University of Pisa, Pisa, Italy
  3. 3Department of Clinical Sciences, University of Rome, Rome, Italy

Received 18 September 2000; Revised 23 November 2000; Accepted 29 November 2000.

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Abstract

We investigated whether plasma chromogranin A (CgA), measured by a new immunoradiometric assay, may be a sensitive and specific marker of phaeochromocytoma and of other neuroendocrine tumours. This study involved 121 patients of whom 20 with phaeochromocytoma, 28 with other neuroendocrine tumours (19 gastroenteropancreatic tumors, 3 medullary thyroid and 6 small cell lung carcinomas), 25 with solid nonfunctioning adrenocortical tumours and 48 with essential hypertension. In addition, 130 normal subjects were taken as controls. Plasma catecholamines were measured by using high-performance liquid chromatography, and CgA by a two-site sandwich immunoradiometric assay involving monoclonal antibodies raised against the unprocessed central domain (145–245) of human CgA. Plasma CgA in controls (49.0 plusminus 3.1 ng ml–1, mean plusminus SE) and in essential hypertensives (50.8 plusminus 3.5 ng ml–1) was lower (P< 0.0001) than in adrenocortical tumours (91.8 plusminus 13.2 ng ml–1), in phaeochromocytomas (254 plusminus 49 ng ml–1) and in patients with other neuroendocrine tumours (469 plusminus 84 ng ml–1). Plasma CgA and catecholamines identified 13 and 18 out of 20 phaeochromocytomas with sensitivity of 65% and 90%, respectively. Combined measurement of both markers improved sensitivity up to 100%. In the other neuroendocrine tumours, CgA was abnormal in 23/28 cases (sensitivity 82%) and in 6 it was the only circulating marker of disease. In gastroenteropancreatic tumours, CgA measurement identified all cases (sensitivity 100%). Specificity of CgA in patients with essential hypertension was 98%. In conclusion, CgA determination showed high sensitivity in identifying gastroenteropancreatic tumours and, in association with catecholamines, in detecting patients with phaeochromocytoma. CgA sometimes appeared to be the only circulating marker of disease. Since the specificity of CgA proved to be excellent, this assay may be useful for diagnosis both of functioning and non-functioning neuroendocrine tumours. © 2001 Cancer Research Campaign

Keywords:

chromogranin A, phaeochromocytoma, neuroendocrine tumours

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