Title:Exploring the Possible Prognostic Role of B-Lymphocyte Stimulator (BLyS) in a Large Series of Patients with Neuroendocrine Tumors
VOLUME: 18 ISSUE: 6
Author(s):Franco Grimaldi*, Fabio Vescini, Veronica Tonelli, Cinzia Pistis, Elda Kara, Vincenzo Triggiani, Elio Tonutti, Francesco Curcio and Martina Fabris
Affiliation:Endocrinology and Metabolism Unit, University Hospital of Udine, Udine, Endocrinology and Metabolism Unit, University Hospital of Udine, Udine, Endocrinology and Metabolism Unit, University Hospital of Udine, Udine, Department of Medical and Biological Sciences, University of Udine, Udine, Endocrinology and Metabolism Unit, University Hospital of Udine, Udine, Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "A. Moro", Bari, Department of Laboratory Medicine, University-Hospital of Udine, Udine, Department of Laboratory Medicine, University-Hospital of Udine, Udine, Department of Laboratory Medicine, University-Hospital of Udine, Udine
Keywords:B-Lymphocyte stimulator, neuroendocrine tumors, prognosis, insulinoma, somatostatin, chromogranin A.
Abstract:Background and Objective: BLyS (B-Lymphocyte stimulator) is over-expressed in several
tumoral settings, with direct or indirect effects on neoplastic proliferation and possibly representing a
therapeutic target. In this study, we explored the role of BLyS in a large population of patients with
neuroendocrine tumors (NETs).
Methods: The study analyzed the stored sera of 124 consecutive unselected patients with NETs: 36
lung carcinoids (24 typical, 12 atypical), 47 gastroenteric tract and 41 pancreatic (30 non-functioning
and 11 functioning: 9 insulinomas, 2 glucagonomas). In 23 cases, BLyS was repeatedly assessed during
the follow-up and the disease was monitored (progression, stabilization or remission) according to
the RECIST criteria. Patients were compared to 92 age and sex-matched blood donors (BDs). Serum
levels of BLyS and Chromogranin A (CgA) were analyzed by ELISA.
Results: NET patients showed significantly higher BLyS levels than BDs (1274±809 pg/ml vs.
587±173 pg/ml; p<0.0001). BLyS correlated weakly with CgA (r=0.19 and p=0.035) but did not correlate
with Ki67, grading, metastasis, histological type and site. In patients with sustained remission after
surgery, BLyS and CgA both showed a gradual reduction over time. Patients with progressing disease
showed higher BLyS levels compared to stable patients (1524±694 pg/ml vs. 1168± 373 pg/ml; p=
0.033). BLyS serum levels remained stable in remission and therapy-controlled patients, while increased
in the follow-up of progressing cases.
Conclusion: Higher BLyS levels identify patients with a more severe disease, characterized by progression
despite treatments, possibly representing a factor implicated in the proliferation of the neoplastic
cells or in sustaining the neoplastic environment.
