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10 results on '"De Apollonia, L"'

6. Videocapsule Endoscopy in Intestinal Neuroendocrine Tumors

Author

Luca Balestreri, L. De Appollonia, Marino Cimitan, T. Lacchin, Mara Fornasarig, Vincenzo Canzonieri, Angela Buonadonna, Renato Cannizzaro, Buonadonna, A, Cannizzaro, R, Borsatti, E, Cimitan, M, Balestreri, L, De Apollonia, L, Frustaci, S, and Canzonieri, V

Subjects
medicine.medical_specialty, Hepatology, Videocapsule Endoscopy, business.industry, Internal medicine, Gastroenterology, medicine, Neuroendocrine tumors, business, medicine.disease
Published
2006

8. Somatostatin receptor scintigraphy versus chromogranin A assay in the management of patients with neuroendocrine tumors of different types: clinical role

Author

R. Ruffo, Angela Buonadonna, Marino Cimitan, L. De Apollonia, Eugenio Borsatti, Renato Cannizzaro, Vincenzo Canzonieri, Cimitan, M, Buonadonna, A, Cannizzaro, R, Canzonieri, V, Borsatti, E, Ruffo, R, and De Apollonia, L

Subjects
Adult, Male, endocrine system, Pathology, medicine.medical_specialty, Lung Neoplasms, Adolescent, Neuroendocrine tumors, Scintigraphy, Sensitivity and Specificity, Diagnosis, Differential, parasitic diseases, medicine, Carcinoma, Chromogranins, Humans, Receptors, Somatostatin, Radionuclide Imaging, Tumor marker, Aged, Gastrointestinal Neoplasms, Neoplasm Staging, biology, medicine.diagnostic_test, Somatostatin receptor, business.industry, Chromogranin A, Hematology, Middle Aged, medicine.disease, Prognosis, Carcinoma, Neuroendocrine, medicine.anatomical_structure, Oncology, biology.protein, Biological Assay, Female, Differential diagnosis, business, Merkel cell
Abstract

Background: Current diagnosis and staging of neuroendocrine tumors (NETs) are significantly improved by the introduction of the chromogranin A (CgA) assay in plasma or serum as a tumor marker, and by the use of somatostatin receptor scintigraphy (SRS) for tumor localization. However, the clinical role of CgA assay compared with SRS in the management of NETs has not been well elucidated. Patients and methods: Sixty-three consecutive patients with a histological diagnosis of NET underwent plasma CgA assay and SRS for tumor staging (23 cases), evaluation of tumor response (18 cases) and evaluation of tumor recurrence on follow-up (22 cases). Twenty-one patients had well-differentiated neuroendocrine tumors (WDNETs: 18 gastroenteropancreatic tumors and three lung NETs); 22 patients had well-differentiated neuroendocrine carcinomas (WDNECs: 17 gastroenteropancreatic carcinomas, two lung neuroendocrine carcinomas and three neuroendocrine carcinomas of unknown origin) and 20 patients had poorly differentiated neuroendocrine carcinomas (PDNECs: 14 extra-pulmonary small-cell carcinomas and six Merkel cell carcinomas). Almost all (58 of 63) NETs were non-functioning. The quantitative determination of CgA was performed in plasma using an enzyme immunoassay with a cut-off value fixed at 34 U/l. Scintigraphies with indium 111‐DTPA-octreotide (111In-pentetreotide) included whole-body images and single photon emission computed tomography (SPECT) scans of the chest and abdomen. Results: SRS results were compared with CgA findings and final clinical data. The overall sensitivity of SRS and CgA, based on the final clinical data, was 77% and 55%, respectively, whereas the specificity of both SRS and CgA was 94%. Concerning tumor type, SRS accuracy was 95% for WDNETs, 86% for WDNECs and 60% for PDNECs; CgA accuracy was 76% for WDNETs, 68% for WDNECs and 50% for PDNECs. With regard to disease extent, SRS sensitivity was 100% for limited disease and 72% for advanced disease; CgA sensitivity was 43% for limited disease and 57% for advanced disease. Conclusions: In our NET series, SRS proved to be more sensitive than CgA, with equivalent specificity. Tumor differentiation influences the sensitivity of SRS and CgA analysis. In addition, the plasma CgA level is related to tumor secretory activity. Nevertheless both SRS and CgA should be considered useful tools in the diagnostic work-up of NET patients.

Published
2003

10. An Italian program of External Quality Control for chromogranin A (CgA) assay: performance evaluation of CgA determination.

Author

Verderio P, Dittadi R, Marubini E, Pizzamiglio S, Gion M, De Apollonia L, and Paradiso A

Subjects
Chemistry, Clinical methods, Enzyme-Linked Immunosorbent Assay methods, Humans, Italy, Laboratories, Quality Control, Reference Standards, Reproducibility of Results, Chromogranin A analysis, Chromogranin A blood, Clinical Laboratory Techniques standards, Enzyme-Linked Immunosorbent Assay standards, Immunoradiometric Assay standards
Abstract

Background: Chromogranin A (CgA) is an acidic glycoprotein produced by many neuroendocrine cells and neurons. Currently, two different methods for assaying CgA, immunoradiometric assay (IRMA) and enzyme-linked immunosorbent assay (ELISA), are widely used in routine practice. Within the framework of a Ministry of Health project, an External Quality Control program was developed to investigate the state of the art of CgA determination in Italy and to monitor the performance of laboratories carrying out this assay. This paper reports the results regarding laboratory performance., Methods: A total of 43 laboratories participated in this program, in which 21 used the ELISA method and 22 the IRMA method. Each laboratory received six samples, three aliquots of serum and three of plasma, at high, intermediate and low concentrations. The results provided by the two assay methods were analyzed separately using two statistical approaches, the principal component analysis and the control chart method., Results: For the IRMA method, questionable results for all samples were obtained by two laboratories, while in two other laboratories performance was questionable for only one sample. For the ELISA method, questionable performances were obtained in only one laboratory for the low and intermediate concentration samples, whereas in three laboratories performance was questionable for only one sample. Interestingly, the coefficients of variation increased approximately five-fold when shifting from the IRMA to the ELISA method., Conclusions: This program demonstrated both the requirement and demand for external quality assessment of CgA assay.

Published
2007
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