title: Chromogranin A expression in patients with hormone naïve prostate cancer predicts the development of hormone refractory disease.
abstract: OBJECTIVE
  We assessed chromogranin A as a tissue biomarker in prostate needle biopsies or as a plasma biomarker, a risk factor for hormone refractory prostate cancer.
  
  
  METHODS
  A total of 211 patients with newly diagnosed prostate cancer treated with luteinizing hormone releasing hormone analogues constituted the study cohort. Univariate and multivariate Cox regression analyses were used to assess the predictive role of tissue and plasma chromogranin A expression.
  
  
  RESULTS
  Chromogranin A expression in less than 30% or in 30% or more tumor cells was significantly associated with a shorter time to hormone refractory disease on univariate analysis (HR 2.0, 95% CI 1.3-3.1 and HR 6.0, 95% CI 2.7-12.9), or on multivariate analysis after adjusting for Gleason score, serum prostate specific antigen and disease stage (HR 1.7, 95% CI 1.0-2.8 and HR 3.9, 95% CI 1.7-9.0), respectively. Plasma chromogranin A measured at baseline (HR 3.0, 95% CI 1.8-5.2), and after 1 year (HR 5.8, 95% CI 3.1-10.1) and 2 years (HR 3.5, 95% CI 1.6-7.6), was predictive of hormone refractory risk confirming the tissue results. Plasma as well as tissue chromogranin A expression negatively correlated with overall survival.
  
  
  CONCLUSIONS
  Chromogranin A expression in prostate cancer biopsies is an independent predictive factor of hormone refractory disease in patients with newly diagnosed prostate cancer on early androgen deprivation therapy. Plasma chromogranin A is also a reliable predictive marker and the predictive significance is maintained over time. These results deserve validation in another data set.
authors.affiliation: Division of Medical Oncology, Department of Clinical & Biological Sciences, University of Turin and San Luigi Hospital, Orbassano, Torino, Italy. alfredo.berruti@gmail.com
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mosca
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.forename: Enrico
authors.initials: E
authors.lastname: Bollito
authors.forename: Marcello
authors.initials: M
authors.lastname: Tucci
authors.forename: Federica
authors.initials: F
authors.lastname: Vana
authors.forename: Cecilia
authors.initials: C
authors.lastname: Cracco
authors.forename: Mirella
authors.initials: M
authors.lastname: Torta
authors.forename: Lucianna
authors.initials: L
authors.lastname: Russo
authors.forename: Susanna
authors.initials: S
authors.lastname: Cappia
authors.forename: Andrea
authors.initials: A
authors.lastname: Saini
authors.forename: Alberto
authors.initials: A
authors.lastname: Angeli
authors.forename: Mauro
authors.initials: M
authors.lastname: Papotti
authors.forename: Roberto Mario
authors.initials: RM
authors.lastname: Scarpa
authors.forename: Luigi
authors.initials: L
authors.lastname: Dogliotti
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D053379:Chromogranin A / Q000032:analysis*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000378:metabolism; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D007987:Gonadotropin-Releasing Hormone