Serum chromogranin A as a screening test for gastric enterochromaffin-like cell hyperplasia during acid-suppressive therapy

Background Serum chromogranin A (CgA), a marker of neuroendocrine neoplasia, increases during profound gastric acid inhibition, possibly reflecting the trophic effect of gastrin on the enterochromaffin‐like (ECL) cells. Aims This study investigated the clinical value of serum CgA as a screening test for gastric fundic enterochromaffin‐like (ECL) cell hyperplasia during acid‐suppressive therapy. Method A consecutive series of 230 dyspeptic patients referred for upper gastrointestinal endoscopy was investigated in a cross‐sectional design. They were 154 patients on continuous medium‐term (6 weeks to one year) or long‐term (longer than one year) acid inhibition with either proton pump inhibitors (PPIs, n = 117) or histamine2‐receptor antagonists (H2RAs, n = 37) for gastro‐oesophageal reflux disease, and 76 nontreated subjects, with normal endoscopic findings (control group). Fasting blood samples were analysed for gastrin and CgA. Gastric biopsy specimens (oxyntic mucosa) were examined for histological evaluation of gastritis (Sydney classification) and of ECL cell hyperplasia (Solcia classification). Results Serum CgA levels correlated positively with serum gastrin, following a quadratic function (r = 0·78, P