Document Detail

Prognostic value of circulating chromogranin A and soluble tumor necrosis factor receptors in advanced nonsmall cell lung cancer.
MedLine Citation:
PMID:  17599769     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increased levels of chromogranin A (CgA), a protein secreted by many neuroendocrine cells, have been detected in sera of patients with neuroendocrine tumors or renal, hepatic, or heart failure. In patients with heart failure, serum CgA correlates with tumor necrosis factor-alpha (TNF) and soluble TNF receptors (sTNF-Rs), with important prognostic implications. The prognostic value of CgA and sTNF-Rs was investigated in advanced nonsmall cell lung cancer (NSCLC), a histologically heterogeneous group of tumors that may undergo neuroendocrine differentiation. METHODS: CgA and sTNF-Rs were analyzed in the sera of 88 patients with NSCLC before chemotherapy by enzyme-linked immunoadsorbent assay (ELISA) and in tumors by immunohistochemistry. RESULTS: Thirteen percent of patients had CgA values greater than the highest value observed in normal subjects (distribution range, 9-724 ng/mL and 28-196 ng/mL, respectively). Immunohistochemical studies showed no correlation between CgA expression in tumors and serum levels. Conversely, circulating CgA was associated with worse Eastern Cooperative Oncology Group (ECOG) performance status (PS) (P = .0005), more advanced stage (P = .042), and survival, with CgA being an independent prognostic factor of poor outcome (hazards ratio [HR] 1.31 for 100 ng/mL increase; 95% confidence interval [95% CI], 1.08-1.60 [P = .0071]). sTNF-R1 and sTNF-R2 were also associated with ECOG PS (P = .0001 and P = .02, respectively). sTNF-Rs was weakly correlated with circulating CgA (r = 0.39 for TNF-R1 and r = 0.40 for TNF-R2), suggesting a regulatory link between sTNF-Rs and CgA secretion. CONCLUSIONS: Increased serum levels of CgA in NSCLC are independent from protein expression in tumors and more likely related to neuroendocrine response associated with worsening of patient condition. In addition to ECOG PS and stage, CgA is an independent indicator of poor prognosis.
Vanesa Gregorc; Anna Spreafico; Irene Floriani; Barbara Colombo; Vienna Ludovini; Lorenza Pistola; Guido Bellezza; Maria Grazia Viganò; Eugenio Villa; Angelo Corti
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  110     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-08     Completed Date:  2007-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  845-53     Citation Subset:  AIM; IM    
Department of Oncology, San Raffaele Scientific Institute, Milan, Italy.
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MeSH Terms
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / blood,  drug therapy,  pathology*
Chromogranin A / analysis,  blood*
Disease Progression
Enzyme-Linked Immunosorbent Assay
Kaplan-Meiers Estimate
Lung / chemistry,  drug effects,  pathology
Lung Neoplasms / blood,  drug therapy,  pathology
Middle Aged
Multivariate Analysis
Neoplasm Staging
Predictive Value of Tests
Receptors, Tumor Necrosis Factor / analysis,  blood*
Treatment Outcome
Reg. No./Substance:
0/Chromogranin A; 0/Receptors, Tumor Necrosis Factor

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