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General markers of neuroendocrine tumours

  • chromogranin A (CgA)
    • a secretory granule, is located alongside specific hormones in large dense-core vesicles of neuronal and neuroendocrine cells
    • CgA is raised in 99% of metastatic carcinoid tumours
  • other general staining markers include pancreatic polypeptide, neuron-specific enolase, peptide histidine-methionine and human chorionic gonadotrophin subunits

Specific markers of carcinoid tumours

  • carcinoid tumours secrete a variety of catecholamines, including serotonin. Diagnosis can be made on the basis of a raised 24 hour urinary level of 5-HIAA - a breakdown product of serotonin; or by whole blood serotonin
    • other urinary markers include neuropeptide K, substance P and other tachykinins
    • urinary hydroxyindole acetic acid (5HIAA) and neuropeptide K show high sensitivity in midgut carcinoid - these markers have less diagnostic usefulness in foregut and hindgut carcinoid
    • if a diagnosis of carcinoid is suspected with normal baseline urinary testing, the pentagastrin test with measurements of plasma tachykinins is a useful diagnostic measure

    Other investigations:

    • radiological localisation of carcinoid tumour
      • somatostatin-receptor-scintigraphy
        • sensitivity 90% and specificity 80%
      • CT
        • may be used preoperatively for localizing tumours- however difficulty detecting tumours <1cm
    • a liver ultrasound scan or CT scan may show evidence of secondaries in the liver.


    1. Endocr Relat Cancer. 2004 Mar;11(1):1-18.


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