title: Serum levels of chromogranin A are not predictive of high-grade, poorly differentiated prostate cancer: results from an Italian biopsy cohort.
abstract: OBJECTIVE
  To explore the association of chromogranin A (CgA) levels and the risk of poorly differentiated prostate cancer (CaP) in men undergoing prostate biopsy.
  
  
  METHODS
  Between 2006 and 2012, we prospectively enrolled 1,018 men with no history of CaP undergoing prostate biopsy. The risk of detecting poorly differentiated CaP as a function of CgA concentration was evaluated using crude and adjusted logistic regressions. Further analyses were performed to determine whether CgA was a significant predictor of high-grade CaP in men with low PSA (<10 ng/ml).
  
  
  RESULTS
  We found a significantly higher level of CgA in men with poorly differentiated CaP. CgA was however co-linear with age, and serum CgA levels were not significantly associated with the overall risk of CaP, and the specific risk of poorly differentiated CaP (OR 1.001 95% CI 0.99-1.01, P = 0.74). Moreover, in men with low PSA levels (<10 ng/ml), CgA was not a significant predictor of high grade-disease on univariate (OR 1.00; 95% CI 0.99-1.01; P = 0.66) and multivariate analysis (P = 0.85).
  
  
  CONCLUSIONS
  In our cohort of patients, the serum level of CgA is not a significant predictor of poorly differentiated CaP on initial prostate biopsy, even in men with low PSA levels (<10 ng/ml). According to our experience, CgA should not be considered a reliable marker to predict poorly differentiate cancer in the setting of initial prostate biopsy.
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy. Electronic address: cosimodenunzio@virgilio.it.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Albisinni
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Presicce
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lombardo
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Cancrini
authors.affiliation: Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D053379:Chromogranin A / Q000097:blood*; D015331:Cohort Studies; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology*; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D017430:Prostate-Specific Antigen