Elena Romano, Maria Rinzivillo, Giuseppe Lamberti, Matteo Marasco, Gianluca Esposito, Davide Campana, Francesco Panzuto
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引用次数: 0
Abstract
Background and objective: Chromogranin A (CgA) is extensively recognized as a biomarker in neuroendocrine neoplasms (NENs) due to its secretion alongside peptide hormones and biogenic amines in neuroendocrine cells. Despite its widespread clinical use, the reliability of CgA as a diagnostic and prognostic tool remains controversial because of its variable expression in various diseases and the influence of factors such as medication and disease characteristics. This review critically examines the role of CgA beyond neuroendocrine contexts, particularly in gastrointestinal conditions where increased levels may mislead clinical diagnostics.
Methods: This review was conducted by performing a search on the PubMed database regarding CgA and both pathological and non-pathological conditions, excluding NENs.
Key content and findings: Conditions such as chronic atrophic gastritis (CAG), proton pump inhibitor usage, and inflammatory bowel diseases (IBDs), among others, can lead to elevated CgA levels, often without any malignant association. Studies reviewed underscore the necessity for cautious interpretation of elevated CgA levels to avoid misdiagnosis and unnecessary anxiety in patients. The review further discusses the implications of non-neuroendocrine diseases contributing to elevated CgA levels, emphasizing the need for improved specificity in testing and a greater awareness among clinicians about the factors influencing CgA levels.
Conclusions: This comprehensive understanding assists in better managing patient outcomes through more accurate diagnosis and appropriate therapeutic interventions.
背景与目的:嗜铬粒蛋白A (Chromogranin A, CgA)在神经内分泌细胞中与多肽激素和生物胺一起分泌,被广泛认为是神经内分泌肿瘤(NENs)的生物标志物。尽管CgA在临床上广泛使用,但由于其在各种疾病中的表达变化以及药物和疾病特征等因素的影响,CgA作为诊断和预后工具的可靠性仍存在争议。这篇综述批判性地探讨了CgA在神经内分泌环境之外的作用,特别是在胃肠道疾病中,CgA水平升高可能会误导临床诊断。方法:本综述通过在PubMed数据库中搜索CgA以及病理和非病理条件(不包括NENs)进行。关键内容和发现:慢性萎缩性胃炎(CAG)、质子泵抑制剂的使用和炎症性肠病(IBDs)等疾病可导致CgA水平升高,通常没有任何恶性关联。回顾的研究强调了谨慎解释CgA水平升高的必要性,以避免误诊和患者不必要的焦虑。本综述进一步讨论了非神经内分泌疾病对CgA水平升高的影响,强调需要提高检测的特异性,并提高临床医生对影响CgA水平的因素的认识。结论:这种全面的理解有助于通过更准确的诊断和适当的治疗干预来更好地管理患者的预后。