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This is from one of the NET sites I paid to register Sherrie's local onco to so he could learn more and have access to experts.
NET diagnosis is complicated by the diverse clinical manifestations of NETs and symptom overlap with other medical conditions. For this reason, biochemical evaluation using various biomarkers is critical for early diagnosis and equally important for monitoring disease progression and therapeutic response. A session chaired by Eugene A. Woltering covered the proper selection, use and validation of predictive and prognostic biomarkers.
Biochemical Evaluation of NETs — Aaron I. Vinik reviewed common misdiagnoses of NETs patients and the biomarkers that help differentiate NETs from other medical conditions. Available biochemical markers include 5-HIAA, chromogranin A (CgA), neurokinin A and Ki67. Selection of the appropriate biomarker depends on tumor type and the information needed (eg, prognosis, extent or site of metastases, treatment response).
Clinical Significance of Biomarkers — Thomas M. O’Dorisio compared the clinical significance and assay reliability of CgA and pancreastatin serum levels. The standard, CgA, is foregut-specific and is an accurate marker for metastasis. However, CgA levels may be elevated due to other conditions and are subject to variation among the different commercial laboratory assays. The newly-developed marker pancreastatin, a derivative of the CgA molecule, appears to have advantages over CgA. It has good specificity and sensitivity and its levels reflect liver tumor burden, which is useful for monitoring therapeutic intervention and disease progression.
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