Circulating Chromogranin A is associated with disease extent, progression and recurrence in patients with non-functioning pancreatic neuroendocrine tumor (NF-PNET).

Abstract

Objectives: Non-functioning Pancreatic Neuroendocrine Tumors (NF-PNET) are rare tumors with heterogeneous biology. Radiology and serum biomarkers are used for post-resection surveillance; however, no universally established protocol exists. Serum Chromogranin A (CgA) concentration is elevated in NF-PNET, and generally correlates with burden of disease; many CgA studies include mixed gastrointestinal and pancreatic populations. We sought to review the NF-PNET literature with focus on post-resection surveillance and hypothesized that CgA is useful for surveillance after NF-PNET resection.

Methods: Comprehensive English literature review by PICO criteria (P-human NF-PNET patients; I-pancreatectomy; C- none; O- CgA correlation with disease recurrence).

Results: Four studies yielded granular data for resected NF-PNET patients. From 333 patients, 113 recurred and 110 (97%) had elevated CgA. Additional 7 studies with mixed gastro-entero-pancreatic NET included 269 NF-PNET patients. In these patients, CgA uniformly predicted disease extent.

Conclusions: Serum Chromogranin A correlates with disease extent in NF-PNET, and is useful for surveillance after resection of NF-PNET.