Background:

The diagnosis and monitoring of primitive lung neuroendocrine tumors (lung pNETs) are usually performed by the measurement of serum chromogranin A (CgA) and urinary 5-hydroxyindolacetic acid (5-HIAA) levels. However, imaging techniques are necessary due to the poor diagnostic efficiency of the laboratory tests.

Methods:

A total-body computed tomography and bone scintigraphy scans showed multiple hepatic and bone metastases of a 55-year-old man affected by well-differentiated lung pNETs without severe initial symptoms. After diagnosis, he started therapy and was monitored with serum, urinary markers, and imaging techniques.

Results:

During follow-up, the urinary 5-HIAA levels did not significantly increase, while serum CgA and urinary para-hydroxyphenylacetic acid (pHPAA) levels (urinary organic acid physiologically present in the urines of healthy subjects) showed significant increases related to worsening clinical condition.

Conclusions:

The early increase in urinary pHPAA levels—usually not dosed in pNET patient monitoring—could be a promising prognostic marker.

中文翻译：

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原始肺神经内分泌肿瘤的潜在预后标志物：病例报告。

背景：

原始肺神经内分泌肿瘤 (肺 pNET) 的诊断和监测通常通过测量血清嗜铬粒蛋白 A (CgA) 和尿 5-羟基吲哚乙酸 (5-HIAA) 水平来进行。然而，由于实验室测试的诊断效率低下，成像技术是必要的。

方法：

全身计算机断层扫描和骨扫描显示一名 55 岁男性的多发肝和骨转移，受高分化肺 pNETs 影响，没有严重的初始症状。诊断后，他开始治疗并接受血清、尿液标志物和成像技术的监测。

结果：

在随访期间，尿 5-HIAA 水平没有显着增加，而血清 CgA 和尿对羟基苯乙酸 (pHPAA) 水平（生理上存在于健康受试者尿液中的尿有机酸）显示出与临床状况恶化相关的显着增加.

结论：

尿 pHPAA 水平的早期增加——通常在 pNET 患者监测中不给药——可能是一个有希望的预后标志物。