Comparison of the utility of Cocaine- and Amphetamine-Regulated Transcript (CART), chromogranin A, and chromogranin B in neuroendocrine tumor diagnosis and assessment of disease progression.

Context: Prognosis in patients with neuroendocrine tumors (NETs) is often poor, frequently reflecting delayed diagnosis. Hence, accurate and practical NET markers are needed. Cocaine- and amphetamine-regulated transcript (CART) peptide is a potential novel NET marker.Design and Participants: Circula...

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Publicado en:Journal of Clinical Endocrinology & Metabolism Vol. 100; no. 4; pp. 1520 - 1529
Autores principales: Ramachandran, R, Bech, P, Murphy, K G, Caplin, M E, Patel, M, Vohra, S, Khan, M S, Dhillo, W S, Sharma, R, Palazzo, F F, Win, Z, Tan, T, Khoo, B, Meeran, K, Frilling, A, Ghatei, M A, Bloom, S R, Martin, N M
Formato: research Journal Article
Publicado: Oxford University Press / USA 2015 Apr
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2015 Apr
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      pub: Oxford University Press / USA
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        atl: Comparison of the utility of Cocaine- and Amphetamine-Regulated Transcript (CART), chromogranin A, and chromogranin B in neuroendocrine tumor diagnosis and assessment of disease progression.
      aug:
        au:
          Ramachandran, R
          Bech, P
          Murphy, K G
          Caplin, M E
          Patel, M
          Vohra, S
          Khan, M S
          Dhillo, W S
          Sharma, R
          Palazzo, F F
          Win, Z
          Tan, T
          Khoo, B
          Meeran, K
          Frilling, A
          Ghatei, M A
          Bloom, S R
          Martin, N M
      sug:
        subj:
          Adrenal Gland Neoplasms Diagnosis
          Protein Precursors Blood
          Nerve Tissue Proteins Blood
          Neuroendocrine Tumors Diagnosis
          Paraganglioma Diagnosis
          Pheochromocytoma Diagnosis
          Tumor Markers, Biological Blood
          Adrenal Gland Neoplasms Blood
          Adult
          Aged
          Aged, 80 and Over
          Case Control Studies
          Disease Progression
          Female
          Human
          Male
          Middle Age
          Neuroendocrine Tumors Blood
          Paraganglioma Blood
          Pheochromocytoma Blood
          Predictive Value of Tests
          Prognosis
          Retrospective Design
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Context: Prognosis in patients with neuroendocrine tumors (NETs) is often poor, frequently reflecting delayed diagnosis. Hence, accurate and practical NET markers are needed. Cocaine- and amphetamine-regulated transcript (CART) peptide is a potential novel NET marker.Design and Participants: Circulating levels of CART peptide and the established NET markers chromogranin A (CgA) and chromogranin B (CgB) were measured using RIA in 353 patients with NET (normal renal function) and in controls. Clinical data were collected retrospectively.Main Outcome Measure(s): The comparative and combined utility of CART, CgA, and CgB for diagnosis and assessment of disease progression was measured in different NET subtypes.Results: CgA and CgB in combination improved diagnostic accuracy in patients with gut NETs, nongastroenteropancreatic NETs, and NETs with an unknown primary origin compared with each biomarker alone. Measuring CART did not further improve diagnosis in these NET subtypes. For pancreatic NETs, CgB was superior to CgA and CART in detecting stable disease (P < .007), whereas CgA and CART in combination were most effective in identifying progressive disease. In phaeochromocytomas/paragangliomas (PCC/PGL), CART was the most useful biomarker for identifying stable (P < .001) and progressive (P = .001) disease. Consistent with this, plasma CART decreased following PCC/PGL tumor resection, remaining low in all patients in remission, but increasing in those with progressive disease.Conclusions: CART is a useful marker for identifying progressive pancreatic NETs. CART is superior to CgA and CgB in detecting stable and progressive PCC/PGLs, and may have a role as a surveillance marker for PCC/PGL patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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