Volume 12 Supplement 1
Elevated serum levels of Chromogranin A in hepatocellular carcinoma
© Biondi et al; licensee BioMed Central Ltd. 2012
Published: 15 November 2012
During the past three decades, the incidence of hepatocellular carcinoma in the United States has tripled. The neuroendocrine character has been observed in some tumor cells within some hepatocellular carcinoma nodules and elevated serum chromogranin A also been reported in patients with hepatocellular carcinoma. The aim of this work was to investigate the role of serum concentration of chromogranin A in patients with hepatocellular carcinoma at different stages.
The study population consisted of 96 patients (63 males and 33 females age range 52-84) at their first hospital admission for hepatocellular carcinoma. The control group consisted of 35 volunteers (20 males and 15 females age range 50-80). The hepatocellular carcinoma patients were stratified according the Barcelona-Clinic Liver Cancer classification. Venous blood samples were collected before treatment from each patients before surgery, centrifuged to obtain serum samples and stored at -80° C until assayed.
The chromogranin A serum levels were elevated (> 100 ng/ml) in 72/96 patients with hepatocellular carcinoma. The serum levels of chromogranin A were significantly correlated (p<0.05) with alpha-fetoprotein. In comparison with controls, the hepatocellular carcinoma patients showed a significant increase (p<0.001) vs controls. The chromogranin A levels in the Barcelona staging of hepatocellular carcinoma was higher in stage D compared to stage C (p<0.01), to stage B (p<0.001), and to stage A (p<0.001).
Molecular markers, such as chromogranin A, could be very useful tools for hepatocellular carcinoma diagnosis. However the molecular classification should be incorporated into a staging scheme, which effectively separated patients into groups with homogeneous prognosis and response to treatment, and thus serves to aid in the selection of appropriate therapy.
During the past three decades, the incidence of hepatocellular carcinoma (HCC) in the United States has tripled with an annual increase of 4.5% . Two diagnostic tests are routinely used to detect HCC in clinical practice: serum α-fetoprotein (AFP) and ultrasonography (US). AFP is a glycoprotein, expressed during the early stages of fetal liver development by the endodermal cells of the visceral yolk sac, in the patients with testis cancer and during hepatocarcinogenesis. The sensitivity of AFP as a diagnostic tool is restricted by the existence of non-AFP-secreting tumors [2–5]. The reliability of ultrasonographic diagnosis depends on a range of factors, including the expertise of the operator, the sophistication of the equipment and the size and nature of the tumor. HCC commonly exhibits histological polymorphism even within a single nodule. The neuroendocrine character has been observed in some tumor cells within some HCC nodules and elevated serum chromogranin A (CgA) also been reported in patients with HCC [6, 7]. CgA is a member of the granin family of acidic secretory glycoproteins that are expressed in all endocrine and neuroendocrine cells, in various autoimmune disease, and correlated with the use of various drugs, such as proton pump inhibitors. CgA has been identified in numerous variety of tumors, including bronchial , prostate , pancreatic and gastrointestinal cancer [10, 11]. The aim of this work was to investigate the role of serum concentration of CgA in patients with HCC at different stages.
Demographic characteristics of subjects included in the study.
Heart rate b\m
88 ± 7
94 ± 7
78 ± 10
Systolic Pressure mmHg
Diastolic Pressure mmHg
Results and discussion
AFP and CgA levels of the subjects included in the study according to the BCLC classification
3.8 ± 1.2
73 ± 10
96 ± 6
24 ± 6
102 ± 10
36 ± 8
125 ± 12
74 ± 24
145 ± 96
128 ± 36
210 ± 110
List of abbreviations
Barcelona-Clinic Liver Cancer
MM and GM were supported by the International PhD program in Neuropharmacology, University of Catania.
This article has been published as part of BMC Surgery Volume 12 Supplement 1, 2012: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery. The full contents of the supplement are available online at http://www.biomedcentral.com/bmcsurg/supplements/12/S1.
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