Neuroendocrine differentiation in stage D2 prostate cancers.
OBJECTIVE
Chromogranin A (CgA) and neuro-specific enolase (NSE) are gaining acceptance as markers of several types of neuroendocrine tumors and the concentration of CgA and NSE have been reported to be elevated in relation to neuroendocrine differentiation of prostate cancer. The aim of the present study was to examine the correlation between the immunohistochemical (IHC) findings and serum value for CgA and NSE in untreated stage D(2) prostate cancer patients.


METHODS
Immunohistochemistry was carried out using antibodies against CgA and NSE in 58 patients and, pretreatment serum CgA and NSE levels were measured by monoclonal immunoradiometric assay in 18 patients with stage D(2) prostate cancer treated by androgen ablation. We examined the relationship of the pretreatment serum level to IHC findings for CgA and NSE in prostate cancer patients to clinicopathological parameters, and prognosis. Also, we evaluated the correlation of IHC findings to serum levels for CgA and NSE.


RESULTS
There was a statistically significant correlation between CgA positivity and serum CgA level (P = 0.0421). However, there was no statistically significant correlation between NSE positivity and serum NSE level (P > 0.05). We divided stage D(2) patients into three groups according to IHC positivity of CgA and NSE. The cause-specific survival was significantly poorer in patients with strongly positive (++) patients for independent CgA and combined CgA with NSE (P = 0.0379). Multivariate analysis of cause-specific survivals in patients with stage D(2) prostate cancer demonstrated that strong IHC stain was considered as independent variable associated with greater risk of death (P = 0.0142).


CONCLUSIONS
Neuroendocrine differentiation in stage D(2) prostate cancer has attracted considerable attention as a potentially findings prognosis. Thus, CgA had a stronger relationship between serum levels and IHC positivity in contrast to NSE, suggesting clinical usefulness as a tumor marker in predicting the extent of neuroendocrine differentiation in prostate cancer.
Kamiya
Naoto
N
Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Suzuki
Hiroyoshi
H
Kawamura
Koji
K
Imamoto
Takashi
T
Naya
Yukio
Y
Tochigi
Naobumi
N
Kakuta
Yukio
Y
Yamaguchi
Kunio
K
Ishikura
Hiroshi
H
Ichikawa
Tomohiko
T
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D053379:Chromogranin A / Q000097:blood*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009490:Neurosecretory Systems / Q000473:pathology; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*
D053379:Chromogranin A; D010751:Phosphopyruvate Hydratase