Development of a highly sensitive and specific carboxy-terminal human pancreastatin assay to monitor neuroendocrine tumor behavior

Pancreas. 2010 Jul;39(5):611-6. doi: 10.1097/MPA.0b013e3181c68d7a.


Objective: Pancreastatin is a fragment of the chromogranin A (CgA) molecule. Existing pancreastatin assays, which depend on antibodies that cross-react in varying percents with the larger prohormone, may lack sensitivity and specificity to detect small changes in neuroendocrine tumor volume.

Methods: We developed a highly specific, sensitive pancreastatin assay. The antibody used recognizes the carboxyl terminal of the peptide hormone and was raised against a 17-amino acid porcine pancreastatin fragment with high homology with the carboxy-terminal amino acids 286-301 of the human CgA.

Results: Our assay measures more than 95% of circulating pancreastatin levels; has little or no cross-reactivity with CgA, even at plasma concentrations of 1000 ng/mL; and can detect pancreastatin levels of 17 pg/mL. Interassay reproducibility for the pancreastatin radioimmunoassay was determined from results of 3 quality control pools in 15 consecutive assays. Coefficients of variation for low, medium, and high pancreastatin levels were less than 20%. The sensitivity of serial pancreastatin assays to detect early liver tumor activity was demonstrated in 2 patients with slowly progressive neuroendocrine tumors and in patients undergoing surgical cytoreduction.

Conclusions: This highly specific, sensitive pancreastatin assay can detect small changes in liver tumor progression and is up to 100-fold more sensitive and specific than CgA assays in the United States.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Biomarkers, Tumor / blood*
  • Chromogranin A / blood
  • Female
  • Humans
  • Liver Neoplasms / blood*
  • Liver Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / blood*
  • Pancreatic Hormones / blood*
  • Radioimmunoassay*
  • Reproducibility of Results


  • Biomarkers, Tumor
  • Chromogranin A
  • Pancreatic Hormones
  • pancreastatin