Role of chromogranin A-derived fragments after resection of nonfunctioning pancreatic neuroendocrine tumors.


Journal

Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 01 11 2021
accepted: 18 01 2022
pubmed: 6 2 2022
medline: 18 5 2022
entrez: 5 2 2022
Statut: ppublish

Résumé

No single reliable biomarker is available for nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs). Vasostatin-1 (VS-1), the N-terminal fragment of chromogranin A (CgA), seems to be a more accurate biomarker compared to its precursor. Primary aim was to investigate the ability of VS-1, compared to total-CgA, to assess the effectiveness of surgical resection performed for NF-PanNETs. Secondary aim was to evaluate two additional CgA-derived fragments, pancreastatin (PST) and vasostatin-2 (VS-2), as possible biomarkers for NF-PanNETs. Consecutive patients who underwent surgery for NF-PanNETs at San Raffaele Scientific Institute were included (n = 35). Plasma levels of CgA and CgA-derived fragments were measured by Enzyme-Linked ImmunoSorbent Assay (ELISA), preoperatively and postoperatively. Preoperative VS-1 was significantly higher compared to VS-1 measured on postoperative day 5 (POD5) (pre: 0.338 nM versus POD5: 0.147 nM, P < 0.001), whereas total-CgA significantly increased after surgery (pre: 1.123 nM versus POD5: 1.949 nM, P = 0.006). Overall, 24 patients showed ≥ 1 feature of tumor aggressiveness (T3-T4, nodal/distant metastases, Ki67 > 5%, microvascular/perineural invasion, necrosis). The median percentage decrease in VS-1 plasma levels was 63% (IQR 28-88%) among patients with aggressive tumors, compared to 13% (IQR 0-57%) in the remaining population (P = 0.033). No significant differences in terms of PST (P = 0.870) and VS-2 (P = 0.909) were observed between preoperative and postoperative time. VS-1 provides an early assessment of surgical efficacy in patients who undergo resection for NF-PanNETs, especially in those with aggressive neoplasms. Total-CgA, PST and VS-2 have no clinical utility in this setting.

Identifiants

pubmed: 35122631
doi: 10.1007/s40618-022-01750-5
pii: 10.1007/s40618-022-01750-5
doi:

Substances chimiques

Biomarkers, Tumor 0
Chromogranin A 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1209-1217

Informations de copyright

© 2022. Italian Society of Endocrinology (SIE).

Références

Dasari A, Shen C, Halperin D et al (2017) Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 3:1335–1342. https://doi.org/10.1001/jamaoncol.2017.0589
doi: 10.1001/jamaoncol.2017.0589 pubmed: 28448665 pmcid: 5824320
Vagefi PA, Razo O, Deshpande V et al (2007) Evolving patterns in the detection and outcomes of pancreatic neuroendocrine neoplasms: the Massachusetts General Hospital experience from 1977 to 2005. Arch Surg 142:347–354. https://doi.org/10.1001/archsurg.142.4.347
doi: 10.1001/archsurg.142.4.347 pubmed: 17438169 pmcid: 3979851
Falconi M, Eriksson B, Kaltsas G et al (2016) ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology 103:153–371. https://doi.org/10.1159/000443171
doi: 10.1159/000443171 pubmed: 26742109
Genç CG, Falconi M, Partelli S et al (2018) Recurrence of pancreatic neuroendocrine tumors and survival predicted by Ki67. Ann Surg Oncol 25:2467–2474. https://doi.org/10.1245/s10434-018-6518-2
doi: 10.1245/s10434-018-6518-2 pubmed: 29789972 pmcid: 6028862
Hashim YM, Trinkaus KM, Linehan DC et al (2014) Regional lymphadenectomy is indicated in the surgical treatment of pancreatic neuroendocrine tumors (PNETs). Ann Surg 259:197–203. https://doi.org/10.1097/SLA.0000000000000348
doi: 10.1097/SLA.0000000000000348 pubmed: 24253141
Partelli S, Javed AA, Andreasi V et al (2018) The number of positive nodes accurately predicts recurrence after pancreaticoduodenectomy for nonfunctioning neuroendocrine neoplasms. Eur J Surg Oncol 44:778–783. https://doi.org/10.1016/j.ejso.2018.03.005
doi: 10.1016/j.ejso.2018.03.005 pubmed: 29610023
Zaidi MY, Lopez-Aguiar AG, Switchenko JM et al (2019) A novel validated recurrence risk score to guide a pragmatic surveillance strategy after resection of pancreatic neuroendocrine tumors: an international study of 1006 patients. Ann Surg 270:422–433. https://doi.org/10.1097/SLA.0000000000003461
doi: 10.1097/SLA.0000000000003461 pubmed: 31283562
Howe JR, Merchant NB, Conrad C et al (2020) The North American neuroendocrine tumor society consensus paper on the surgical management of pancreatic neuroendocrine tumors. Pancreas 49:1–33. https://doi.org/10.1097/MPA.0000000000001454
doi: 10.1097/MPA.0000000000001454 pubmed: 31856076 pmcid: 7029300
Jilesen APJ, Busch ORC, van Gulik TM et al (2014) Standard pre- and postoperative determination of chromogranin a in resectable non-functioning pancreatic neuroendocrine tumors–diagnostic accuracy: NF-pNET and low tumor burden. Dig Surg 31:407–414. https://doi.org/10.1159/000370007
doi: 10.1159/000370007 pubmed: 25572908
Partelli S, Andreasi V, Muffatti F et al (2020) Circulating neuroendocrine gene transcripts (NETest): a postoperative strategy for early identification of the efficacy of radical surgery for pancreatic neuroendocrine tumors. Ann Surg Oncol 27:3928–3936. https://doi.org/10.1245/s10434-020-08425-6
doi: 10.1245/s10434-020-08425-6 pubmed: 32253675
Marotta V, Zatelli MC, Sciammarella C et al (2018) Chromogranin A as circulating marker for diagnosis and management of neuroendocrine neoplasms: more flaws than fame. Endocr Relat Cancer 25:R11–R29. https://doi.org/10.1530/ERC-17-0269
doi: 10.1530/ERC-17-0269 pubmed: 29066503
Oberg K (2011) Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer 18(Suppl 1):S17-25. https://doi.org/10.1530/ERC-10-0280
doi: 10.1530/ERC-10-0280 pubmed: 22005113
Andreasi V, Partelli S, Muffatti F et al (2021) Update on gastroenteropancreatic neuroendocrine tumors. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver 53:171–182. https://doi.org/10.1016/j.dld.2020.08.031
doi: 10.1016/j.dld.2020.08.031
Giusti M, Sidoti M, Augeri C et al (2004) Effect of short-term treatment with low dosages of the proton-pump inhibitor omeprazole on serum chromogranin A levels in man. Eur J Endocrinol 150:299–303. https://doi.org/10.1530/eje.0.1500299
doi: 10.1530/eje.0.1500299 pubmed: 15012614
Pregun I, Herszenyi L, Juhasz M et al (2011) Effect of proton-pump inhibitor therapy on serum chromogranin a level. Digestion 84:22–28. https://doi.org/10.1159/000321535
doi: 10.1159/000321535 pubmed: 21304238
Dam G, Grønbæk H, Sorbye H et al (2020) Prospective study of chromogranin a as a predictor of progression in patients with pancreatic, small-intestinal, and unknown primary neuroendocrine tumors. Neuroendocrinology 110:217–224. https://doi.org/10.1159/000503833
doi: 10.1159/000503833 pubmed: 31578011
Brehm Hoej L, Parkner T, Soendersoe Knudsen C, Grønbaek H (2014) A comparison of three chromogranin A assays in patients with neuroendocrine tumours. J Gastrointestin Liver Dis 23:419–424. https://doi.org/10.15403/jgld.2014.1121.234.3ca
Baekdal J, Krogh J, Klose M et al (2020) Limited diagnostic utility of chromogranin a measurements in workup of neuroendocrine tumors. Diagnostics (Basel, Switzerland) 10:881. https://doi.org/10.3390/diagnostics10110881
doi: 10.3390/diagnostics10110881
Giovinazzo F, Schimmack S, Svejda B et al (2013) Chromogranin A and its fragments as regulators of small intestinal neuroendocrine neoplasm proliferation. PLoS One 8:e81111. https://doi.org/10.1371/journal.pone.0081111
doi: 10.1371/journal.pone.0081111 pubmed: 24260544 pmcid: 3834250
Corsello A, Di Filippo L, Massironi S et al (2018) Vasostatin-1: A novel circulating biomarker for ileal and pancreatic neuroendocrine neoplasms. PLoS ONE 13:e0196858. https://doi.org/10.1371/journal.pone.0196858
doi: 10.1371/journal.pone.0196858 pubmed: 29723285 pmcid: 5933774
Sherman SK, Maxwell JE, O’Dorisio MS et al (2014) Pancreastatin predicts survival in neuroendocrine tumors. Ann Surg Oncol 21:2971–2980. https://doi.org/10.1245/s10434-014-3728-0
doi: 10.1245/s10434-014-3728-0 pubmed: 24752611 pmcid: 4125469
Andreasi V, Partelli S, Manzoni M et al (2019) Association between preoperative Vasostatin-1 and pathological features of aggressiveness in localized nonfunctioning pancreatic neuroendocrine tumors (NF-PanNET). Pancreatology 19:57–63. https://doi.org/10.1016/j.pan.2018.11.005
doi: 10.1016/j.pan.2018.11.005 pubmed: 30470614
Bossuyt PM, Reitsma JB, Bruns DE et al (2015) STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 351:h5527. https://doi.org/10.1136/bmj.h5527
doi: 10.1136/bmj.h5527 pubmed: 26511519 pmcid: 4623764
Crippa L, Bianco M, Colombo B et al (2013) A new chromogranin A-dependent angiogenic switch activated by thrombin. Blood 121:392–402. https://doi.org/10.1182/blood-2012-05-430314
doi: 10.1182/blood-2012-05-430314 pubmed: 23190532 pmcid: 3544118
Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
doi: 10.1097/01.sla.0000133083.54934.ae pubmed: 15273542 pmcid: 1360123
Rindi G, Kloppel G, Alhman H et al (2006) TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 449:395–401. https://doi.org/10.1007/s00428-006-0250-1
doi: 10.1007/s00428-006-0250-1 pubmed: 16967267 pmcid: 1888719
Lloyd RV, Osamura RY, Kloppel G, Rosai J (2017) WHO Classification of Tumours of Endocrine Organs, 4th edn. IARC Press, Lyon
Oberg K, Modlin IM, De Herder W et al (2015) Consensus on biomarkers for neuroendocrine tumour disease. Lancet Oncol 16:e435–e446. https://doi.org/10.1016/S1470-2045(15)00186-2
doi: 10.1016/S1470-2045(15)00186-2 pubmed: 26370353 pmcid: 5023063
Tran CG, Sherman SK, Scott AT et al (2021) It is time to rethink biomarkers for surveillance of small bowel neuroendocrine tumors. Ann Surg Oncol 28:732–741. https://doi.org/10.1245/s10434-020-08784-0
doi: 10.1245/s10434-020-08784-0 pubmed: 32656719
Woltering EA, Voros BA, Beyer DT et al (2019) Plasma pancreastatin predicts the outcome of surgical cytoreduction in neuroendocrine tumors of the small bowel. Pancreas 48:356–362. https://doi.org/10.1097/MPA.0000000000001263
doi: 10.1097/MPA.0000000000001263 pubmed: 30768573
Pulvirenti A, Rao D, Mcintyre CA et al (2019) Limited role of Chromogranin A as clinical biomarker for pancreatic neuroendocrine tumors. HPB (Oxford) 21:612–618. https://doi.org/10.1016/j.hpb.2018.09.016
doi: 10.1016/j.hpb.2018.09.016
Tseng C-M, Cheng T-Y, Chen T-B et al (2018) Low accuracy of chromogranin A for diagnosing early-stage pancreatic neuroendocrine tumors. Oncol Lett 15:8951–8958. https://doi.org/10.3892/ol.2018.8472
doi: 10.3892/ol.2018.8472 pubmed: 29805630 pmcid: 5958764
Qiu W, Christakis I, Silva A et al (2016) Utility of chromogranin A, pancreatic polypeptide, glucagon and gastrin in the diagnosis and follow-up of pancreatic neuroendocrine tumours in multiple endocrine neoplasia type 1 patients. Clin Endocrinol (Oxf) 85:400–407. https://doi.org/10.1111/cen.13119
doi: 10.1111/cen.13119
Strosberg D, Schneider EB, Onesti J et al (2018) Prognostic impact of serum pancreastatin following chemoembolization for neuroendocrine tumors. Ann Surg Oncol 25:3613–3620. https://doi.org/10.1245/s10434-018-6741-x
doi: 10.1245/s10434-018-6741-x pubmed: 30182331
Woltering EA, Beyer DT, Thiagarajan R et al (2016) Elevated plasma pancreastatin, but not chromogranin a, predicts survival in neuroendocrine tumors of the duodenum. J Am Coll Surg 222:534–542. https://doi.org/10.1016/j.jamcollsurg.2015.12.014
doi: 10.1016/j.jamcollsurg.2015.12.014 pubmed: 26827125
Pavel M, Jann H, Prasad V et al (2017) NET Blood Transcript Analysis Defines the Crossing of the Clinical Rubicon: When Stable Disease Becomes Progressive. Neuroendocrinology 104:170–182. https://doi.org/10.1159/000446025
doi: 10.1159/000446025 pubmed: 27078712
Laskaratos F-M, Liu M, Malczewska A et al (2020) Evaluation of circulating transcript analysis (NETest) in small intestinal neuroendocrine neoplasms after surgical resection. Endocrine 69:430–440. https://doi.org/10.1007/s12020-020-02289-2
doi: 10.1007/s12020-020-02289-2 pubmed: 32291735 pmcid: 7392928
Modlin IM, Kidd M, Frilling A et al (2021) Molecular genomic assessment using a blood-based mRNA signature (NETest) is cost effective and predicts neuroendocrine tumor recurrence with 94% accuracy. Ann Surg 274:481–490. https://doi.org/10.1097/SLA.0000000000005026
doi: 10.1097/SLA.0000000000005026 pubmed: 34183517
Modlin IM, Kidd M, Oberg K et al (2021) Early identification of residual disease after neuroendocrine tumor resection using a liquid biopsy multigenomic mRNA signature (NETest). Ann Surg Oncol 28:7506–7517. https://doi.org/10.1245/s10434-021-10021-1
doi: 10.1245/s10434-021-10021-1 pubmed: 34008138
Oberg K, Krenning E, Sundin A et al (2016) A Delphic consensus assessment: imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management. Endocr Connect 5:174–187. https://doi.org/10.1530/EC-16-0043
doi: 10.1530/EC-16-0043 pubmed: 27582247 pmcid: 5045519

Auteurs

V Andreasi (V)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.
Tumor Biology and Vascular Targeting Unit, Experimental Oncology Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.

S Partelli (S)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.

M F Manzoni (MF)

San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.
Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

F Muffatti (F)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.

L Di Filippo (L)

San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.
Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

S Crippa (S)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.

A Corti (A)

Vita-Salute San Raffaele University, Milan, Italy.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy.
Tumor Biology and Vascular Targeting Unit, Experimental Oncology Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.

M Falconi (M)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy. falconi.massimo@hsr.it.
Vita-Salute San Raffaele University, Milan, Italy. falconi.massimo@hsr.it.
San Raffaele Hospital Neuroendocrine Tumor Group (ENETS Center of Excellence), Milan, Italy. falconi.massimo@hsr.it.

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