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ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Biochemical Markers
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrine Tumor Biology.ORCID iD: 0000-0002-3432-1182
Hospital Beaujon, Department of Pathology.
Ospedale Sant’Andrea, Department of Digestive and Liver Disease.
Hadassah University Hospital, Department of Endocrinology and Metabolism.
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2017 (English)In: Neuroendocrinology, ISSN 0028-3835, E-ISSN 1423-0194, Vol. 105, no 3, p. 201-211Article in journal (Refereed) Published
Abstract [en]

Biomarkers have been the mainstay in the diagnosis and follow-up of patients with neuroendocrine tumors (NETs) over the last few decades. In the beginning, secretory products from a variety of subtypes of NETs were regarded as biomarkers to follow during diagnosis and treatment: serotonin for small intestinal (SI) NETs, and gastrin and insulin for pancreatic NETs. However, it became evident that a large number of NETs were so-called nonfunctioning tumors without secreting substances that caused hormone-related symptoms. Therefore, it was necessary to develop so-called "general tumor markers." The most important ones so far have been chromogranin A and neuron-specific enolase (NSE). Chromogranin A is the most important general biomarker for most NETs with a sensitivity and specificity somewhere between 60 and 90%. NSE has been a relevant biomarker for patients with high-grade tumors, particularly lung and gastrointestinal tract tumors. Serotonin and the breakdown product urinary 5-hydroxyindoleacetic acid (U-5-HIAA) is still an important marker for diagnosing and follow-up of SI NETs. Recently, 5-HIAA in plasma has been analyzed by highperformance liquid chromatography and fluorometric detection and has shown good agreement with U-5-HIAA anal ysis. In the future, we will see new tests including circulating tumor cells, circulating DNA and mRNA. Recently, a NET test has been developed analyzing gene transcripts in circulating blood. Preliminary data indicate high sensitivity and specificity for NETs. However, its precise role has to be validated in prospective randomized controlled trials which are ongoing right now.

Place, publisher, year, edition, pages
2017. Vol. 105, no 3, p. 201-211
Keyword [en]
Biomarkers, Chromogranin A, Urinary 5-hydroxyindoleacetic acid, Neuroendocrine tumor test
National Category
Endocrinology and Diabetes Neurology
Identifiers
URN: urn:nbn:se:uu:diva-336660DOI: 10.1159/000472254ISI: 000411501200003PubMedID: 28391265OAI: oai:DiVA.org:uu-336660DiVA, id: diva2:1170745
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-01-04Bibliographically approved

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Öberg, KjellWelin, Staffan

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