The role of the acute octreotide suppression test in detecting patients with neuroendocrine neoplasms

Scientific paper - Original scientific paper

• Author: Ivan Kruljac
• Author: Ivan Vičić
• Author: Kristina Blaslov
• Author: Zorica Kolak
• Author: Martina Benković
• Author: Davor Kust
• Author: Blaženka Ladika Davidović
• Author: Gordan Tometić
• Author: Ivan Penavić
• Author: Nina Dabelić
• Author: Ljubica Vazdar
• Author: Tajana Pavić
• Author: Milan Vrkljan
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Background: Serum chromogranin A (CgA) is routinely used as a biomarker in patients with neuroendocrine neoplasms (NENs). Several conditions and comorbidities may be associated with falsely elevated CgA, often leading to extensive diagnostic evaluation, which may be costly and harmful. The aim of this study was to analyze the effectiveness of the acute octreotide suppression test (AOST) in differentiating falsely elevated serum CgA.
----- Methods: Our prospective study enrolled 45 patients from two different patient cohorts: (1) 29 patients with suspicion or presence of NENs (extensive workup and subsequent biopsy confirmed 16 NENs); (2) 16 consecutive patients admitted via the Emergency Department without NENs (non-NENs). AOST was performed after an overnight fast. Baseline CgA was measured, after which 0.25 mg of octreotide was administered subcutaneously. CgA was measured 3 and 6 h after administration.
----- Results: Baseline CgA levels were similar in NENs and non-NENs. At the end of the AOST, CgA decreased by a median of 83.3% (41.0-127.4) in non-NENs and 13.8% (0.0-43.6) in NENs (p < 0.001). In patients with increased baseline CgA, a decrease in CgA at the 6th hour of < 51.3% had 90.0% sensitivity and 88.9% specificity in detecting NENs. In patients with normal baseline serum CgA, a decrease in CgA at the 3rd hour of < 17.6% had 83.3% sensitivity and 81.8% specificity in detecting patients with NENs. The diagnostic accuracy of the AOST in the entire study population was 86.7%.
----- Conclusions: AOST is a promising tool to increase the diagnostic accuracy of serum CgA.

• Keywords (english): Aged; Biomarkers, Tumor / blood; Chromogranin A / blood; Female; Humans; Intestinal Neoplasms / blood; Intestinal Neoplasms / diagnosis; Male; Middle Aged; Neuroendocrine Tumors / blood; Neuroendocrine Tumors / diagnosis; Octreotide; Pancreatic Neoplasms / blood; Pancreatic Neoplasms / diagnosis; Prospective Studies; Sensitivity and Specificity
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Neuroendocrinology
• Numbering: vol. 107, no. 3, pp. 284-291
• p-ISSN: 0028-3835
• DOI: https://doi.org/10.1159/000492934
• URN:NBN: urn:nbn:hr:105:609482
• Publication: 2018
• Document URL: http://doi.org/10.1159/000492934
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 10:31:05