Evidence map›Paper›PMID 40455177›Full record

ArticleEndocrine2025

Chromogranin a and pancreatic polypeptide are not suitable for the screening of pancreatic neuroendocrine tumors in MEN1 - a long-term follow-up study.

Iiro Kostiainen, Susanna Majala, Jukka Schildt, Helka Parviainen, Saila Kauhanen, Niina Matikainen, Eeva M Ryhänen, Camilla Schalin-Jäntti

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Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Iiro KostiainenEndocrinology, Abdominal Center, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland. iiro.kostiainen@hus.fi.ORCID 0000-0002-2358-1181
Susanna MajalaDepartment of Surgery, Division of Digestive Surgery and Urology, Turku University Hospital and University of Turku, Turku, Finland.
Jukka SchildtHUS Medical Imaging Center, Department of Clinical Physiology and Nuclear Medicine, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland.
Helka ParviainenHUS Medical Imaging Center, Department of Radiology, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland.
Saila KauhanenDepartment of Surgery, Division of Digestive Surgery and Urology, Turku University Hospital and University of Turku, Turku, Finland.
Niina MatikainenEndocrinology, Abdominal Center, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland.ORCID 0000-0003-0041-1240
Eeva M RyhänenEndocrinology, Abdominal Center, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland.
Camilla Schalin-JänttiEndocrinology, Abdominal Center, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland.ORCID 0000-0002-2428-0161

Funding

Helsingin ja Uudenmaan Sairaanhoitopiiri TYH2020334
6 · The paper itself

Abstract

purposeIn patients with multiple endocrine neoplasia type 1 (MEN1) followed up at ENETS centers of Excellence, chromogranin A (CgA) and pancreatic polypeptide (PP) are widely used screening tools for pancreatic neuroendocrine tumors (panNETs). Previous studies have demonstrated conflicting results regarding their performance in MEN1. This retrospective study aims to bring clarity to the question by investigating a well-characterized MEN1 cohort. We studied the impact of long-term biomarker follow-up on the clinical management of panNETs in MEN1.

methodsWe calculated the sensitivity and specificity and performed ROC analysis of CgA and PP for diagnosing any panNET, ≥20 mm panNET, and metastatic panNET in comparison to imaging reference standard in 58 MEN1 patients. All patients had undergone somatostatin receptor PET/CT and conventional imaging. Longitudinal impact of 10-year annual biomarker measurements on real-life clinical management was analyzed from patient records.

resultsSensitivity of CgA (n = 48) and PP (n = 47) for diagnosing any panNET, ≥20 mm panNET, and metastatic panNET was 35%, 30%, and 60 and 23%, 33%, and 0%, respectively. For CgA, the AUC for diagnosing any panNET, ≥20 mm panNET, and metastatic panNET was 0.30 (95% CI 0.09-0.51), 0.49 (95% CI 0.29-0.68), and 0.69 (95% CI 0.42-0.95), respectively. For PP, the AUC for detection of metastatic panNET was 0.28 (95% CI 0.11-0.46). The annual biomarker measurements during 514 patient-years of follow-up did not affect the clinical management of panNETs.

conclusionCgA and PP are not helpful in diagnosing panNETs in MEN1. It is time to revise the surveillance protocols in practice.

Indexed as

Biomarkers, TumorChromogranin AMultiple Endocrine Neoplasia Type 1Neuroendocrine TumorsPancreatic NeoplasmsPancreatic PolypeptideAdultAgedEarly Detection of CancerFemaleFollow-Up StudiesHumansMaleMiddle AgedPositron Emission Tomography Computed TomographyRetrospective StudiesBiomarkers, TumorChromogranin APancreatic PolypeptideChromogranin AMEN1Pancreatic neuroendocrine tumorPancreatic polypeptideSomatostatin receptor PET/CT

Identifiers

PMID40455177
PMCPMC12370824

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.