The role of elevated serum procalcitonin in neuroendocrine neoplasms of digestive system

Introduction: Elevated serum procalcitonin (PCT) was reported in patients with certain type of neuroendocrine neoplasms (NENs). Objective: The aim of this study was to assess the role of elevated serum PCT in NENs from digestive system. Patients and methods: Serum PCT and serum CgA level were measured in 155 patients with NENs from digestive system. Results: Elevated serum PCT was found in 63 patients (40.6%). Grade 3 disease was a significant factor associated with elevated serum PCT (OR, 9.24; 95% CI, 3.04-28.08; P < 0.001). Serum PCT level was significantly decreased after treatment both in patients with stable disease (P = 0.003) and patients with partial remission (P = 0.001). In these patients, serum PCT level significantly increased again at the time of progression disease (P = 0.001). Elevated serum PCT was a significant factor of worse survival (HR, 2.86; 95% CI, 1.36-6.03; P = 0.006). Compared with patients with normal serum PCT and CgA level, patients with either PCT or CgA elevated and patients with both PCT and CgA elevated had progressively worse survival. Additionally, PCT expression in tumor cells was found in 24.0% of patients but did not correlate with other clinicopathological factors, including serum PCT. Conclusions: Serum PCT is elevated in part of patients with NENs of digestive system, especially in patients with grade 3 disease. Serum PCT level can help evaluate treatment response and its elevation indicates poor prognosis. Combination of serum PCT and CgA can improve outcome prediction.