An elevated progastrin-releasing peptide level in patients with well-differentiated neuroendocrine tumours indicates a primary tumour in the lung and predicts a shorter survival

C. M. Korse, B. G. Taal, J. M.G. Bonfrer, A. Vincent, M. L. Van velthuysen, P. Baas

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23 Citations (Scopus)


Background: Progastrin-releasing peptide (proGRP) is a recently identified biomarker of small-cell lung cancer. In well-differentiated neuroendocrine tumours (WDNETs), this study investigates the association between proGRP and tumour characteristics and the prognostic value of proGRP levels compared with chromogranin A (CgA) levels.Patients and methods: Serum samples were obtained in 282 patients with WDNET. The receiver operating characteristic (ROC) curve technique was used to assess specificity and sensitivity in the identification of a primary tumour location. Cox proportional hazards models and Kaplan-Meier curves were constructed to determine the association of patients' characteristics and tumour markers with survival.Results: For proGRP, the ROC curve indicated a cut-off level of 90 ng/l (approximately twice the upper reference value), with a specificity of 99% and a sensitivity of 43% in distinguishing primary pulmonary tumours from other sites. In the multivariate Cox model, both proGRP and CgA were strongly associated with survival (P < 0.0001 for both variables).Conclusions: A high-risk proGRP level (more than twice the upper reference value) in patients with WDNETs is a strong indication for a primary tumour in the lung. Besides CgA, proGRP is a complementary tumour marker for prognosis and treatment monitoring in patients with neuroendocrine tumour.

Original languageEnglish
Article numbermdr007
Pages (from-to)2625-2630
Number of pages6
JournalAnnals of Oncology
Issue number12
Publication statusPublished or Issued - Dec 2011
Externally publishedYes


  • Chromogranin A
  • Diagnosis
  • Neuroendocrine tumours
  • Progastrin-releasing peptide
  • Prognosis
  • Survival analysis

ASJC Scopus subject areas

  • Hematology
  • Oncology

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