Neuroendocrine differentiation in colorectal carcinomas: assessing its prognostic significance.
OBJECTIVE
There is evidence that colorectal carcinomas with extensive neuroendocrine features have a substantially worse prognosis than those without, but the frequency and clinical significance of neuroendocrine features in conventional carcinomas has not been settled since few studies have been performed, with conflicting results. The aim of the study was to investigate neuroendocrine differentiation in colorectal carcinomas in relation to its prognostic significance.


METHODS
In 50 patients with colorectal carcinoma, the extent and intensity of staining with each of the three antibodies (chromogranin A, neuron-specific enolase and synaptophysin) were determined and correlated with the histologic type, grade, stage of the tumor and survival time ot the patients.


RESULTS
We observed chromogranin A expression in 38%, neuron-specific enolase expression in 26%, and synaptophysin expression in 6% of the tumors. Chromogranin A was the most frequently and strongly expressed marker in our study. Of the three antibodies studied, only chromogranin A positivity was correlated with grade and stage of the tumors and was associated with a decreased effect on survival.


CONCLUSIONS
Our results show that chromogranin A is the most sensitive and specific neuroendocrine marker. Chromogranin A positivity appears to bear a poor prognosis in patients with colorectal cancers.
Atasoy
Pinar
P
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey. cetinatasoy@hotmail.com
Ensari
Arzu
A
Demirci
Salim
S
Kurşun
Nazmiye
N
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry* / Q000473:pathology*; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000737:chemistry* / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016708:Synaptophysin / Q000032:analysis
D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D016708:Synaptophysin