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Clinical utility of chromogranin A for surveillance of succinate dehydrogenase B- and D-related paraganglioma

Citation

Thompson, M and Parameswaran, V and Burgess, J, Clinical utility of chromogranin A for surveillance of succinate dehydrogenase B- and D-related paraganglioma, Annals of clinical biochemistry ISSN 0004-5632 (2018) [Refereed Article]


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DOI: doi:10.1177%2F0004563218811865

Abstract

Background: Patients with mutations of succinate dehydrogenase B (SDHB) and D (SDHD) are at high risk of paraganglioma (PGL) necessitating surveillance. Chromogranin A (CgA) has been proposed as a biochemical marker of PGL. We sought to determine the diagnostic utility of CgA in a population based SDHx sample.

Methods: Tasmania is an island state with one tertiary referral centre for endocrine neoplasia. We performed cross sectional analysis of all adult SDHB (n=52) and SDHD (n=10) patients undergoing PGL surveillance between 2011 and 2017. CgA was referenced against the outcome of PGL surveillance with a minimum of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and plasma metanephrines (metanephrine and normetanephrine).

Results: CgA correctly predicted the result of PGL surveillance more often in patients with SDHB compared to those with SDHD (77% vs 22%, p=0.003). In the SDHB group, CgA demonstrated a sensitivity of 67% and specificity of 79% compared to 22% and 0% in the SDHD group. CgA identified one of three PET/CT-visualised SDHB-related PGLs with normal plasma metanephrines at the expense of nine false positive results. A normal CgA demonstrated a negative predictive value of 92% for SDHB-related PGL. In patients with SDHB, plasma normetanephrine and metanephrine offered superior specificity (100%, p=0.01 and 100%, p<0.01, respectively) with comparable sensitivity (67%, p=1.0 and 11%, p=0.06, respectively) to CgA.

Conclusion: CgA does not provide additive benefit to standard surveillance for predicting the presence of SDHB- or SDHD-related PGL, but has a useful negative predictive value when normal in patients with SDHB mutation.

Item Details

Item Type:Refereed Article
Keywords:Chromogranin A, paraganglioma, SDHx
Research Division:Medical and Health Sciences
Research Group:Oncology and Carcinogenesis
Research Field:Oncology and Carcinogenesis not elsewhere classified
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Endocrine Organs and Diseases (excl. Diabetes)
Author:Burgess, J (Professor John Burgess)
ID Code:129051
Year Published:2018
Deposited By:Medicine (Discipline)
Deposited On:2018-11-06
Last Modified:2018-11-08
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