Chromogranin A (CgA) is a granin-family secretory protein expressed ubiquitously in neuro...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-CHROMOGRANIN-A-NET-MEN1-SURVEILLANCE |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-05-18 | actionability review required |
| Diseases | DIS-PNET |
| Sources | SRC-ENDOCRINE-SOCIETY-MEN-2023 SRC-NCCN-NET-2025 |
Actionability Facts
| Biomarker | BIO-CHROMOGRANIN-A-NET |
|---|---|
| Variant | Chromogranin A — neuroendocrine tumour surveillance / MEN1 carrier |
| Disease | DIS-PNET |
| ESCAT tier | X |
| Recommended combinations | MEN1 carrier surveillance: CgA + disease-specific hormone panels (gastrin, insulin/proinsulin/C-peptide, glucagon, VIP) per Endocrine Society MEN 2023, GEP-NET follow-up: CgA trend alongside imaging (CT/MRI or 68Ga-DOTATATE PET); discordant rising CgA without imaging change → restage |
| Contraindicated monotherapy | Do not interpret CgA in isolation — PPI/H2-blocker withdrawal ≥2 weeks before draw or interpret with PPI status known |
| Evidence summary | Chromogranin A (CgA) is a granin-family secretory protein expressed ubiquitously in neuroendocrine cells. Serum CgA is used as a biomarker of GEP-NET tumour bulk and treatment response, and as an adjunct in MEN1 carrier surveillance alongside disease-specific hormones (gastrin, insulin, glucagon, VIP). Specificity is LOW — PPI use (massive false-positive elevation), renal impairment, heart failure, atrophic gastritis, and assay-platform variability all confound interpretation. Sensitivity ~60-90% across NET subtypes (highest in functional small-bowel NET, lowest in pNET / insulinoma). ESCAT X — CgA does not drive treatment selection independently; it is a trend-monitoring tool only. NCCN NET 2025 and Endocrine Society MEN 2023 acknowledge CgA but emphasise its limitations. |
Notes
STUB pending two-Co-Lead signoff. CgA's chief value is trend-monitoring in a known-NET patient on stable PPI status — absolute single-time-point values are not interpretable. Render layer should display CgA alongside PPI / renal-function status. Disease-specific hormones (gastrin, insulin, glucagon, VIP, PP) are the primary functional NET biomarkers and should be requested in parallel.
Used By
No reverse references found in the YAML corpus.