ANNALS EXPRESS: Clinical utility of chromogranin A for surveillance of succinate dehydrogenase B- and D-related paraganglioma:

Background Patients with mutations of succinate dehydrogenase B (SDHB) and D (SDHD) are at high risk of paraganglioma (PGL) necessitating surveillance. Chromogranin A (CgA) has been proposed as a biochemical marker of PGL. We sought to determine the diagnostic utility of CgA in a population based SDHx sample.MethodsTasmania is an island state with one tertiary referral centre for endocrine neoplasia. We performed cross sectional analysis of all adult SDHB (n=52) and SDHD (n=10) patients undergoing PGL surveillance between 2011 and 2017. CgA was referenced against the outcome of PGL surveillance with a minimum of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and plasma metanephrines (metanephrine and normetanephrine).Results CgA correctly predicted the result of PGL surveillance more often in patients with SDHB compared to those with SDHD (77% vs 22%, p=0.003). In the SDHB group, CgA demonstrated a sensitivity of 67% and specificity of 79% compared to 22% and 0% i...