title: The Prognostic Significance of Neuroendocrine Differentiation in Colorectal Carcinomas: Our Experience.
abstract: BACKGROUND
  Neuroendocrine differentiation in colorectal carcinomas, detected using immunohistochemistry and ultrastructural techniques, has been studied as a prognostic marker for invention of targeted therapy. There are a few studies done on this aspect which have shown conflicting results ranging from poor prognosis to no prognostic significance.
  
  
  OBJECTIVE
  The aim of the study was to determine the clinical significance of neuroendocrine differentiation in colorectal carcinomas using immunohistochemical stains such as chromogranin A & synaptophysin in relation to its prognostic significance.
  
  
  METHODS
  A retrospective study was conducted wherein all the colorectal carcinomas, received in the Department of Pathology, over a period of 3 years, were reviewed. Neuroendocrine markers were done on 53 cases of moderately, poorly and undifferentiated adenocarcinomas. Based on the degree of immunoreactivity for these markers, tumours were divided into group 0, group 1, group 2, group 3 & group 4. Group 0 & 1 were categorized as neuroendocrine differentiation absent & group 2, 3 & 4 as present. Neuroendocrine differentiation was correlated with age, sex, grade, stage, diagnosis & survival. Follow up data of the cases was recorded.
  
  
  RESULTS
  Neuroendocrine differentiation was present in 18 cases (33.9%). The degree of immunoreactivity for neuroendocrine markers in present study were; group 0- 58%, 1- 7.5%, 2- 9%, 3- 13% & 4- 11%. The mean age of patients was 54 years with a slight male preponderance {M:F::1.6:1}. Most of the carcinomas with neuroendocrine differentiation belonged to Grade II (61%) & Stage II & III (83%). Neuroendocrine differentiation did not show any significant association with age, sex, location, histological type, grade, stage & survival.
  
  
  CONCLUSIONS
  The above results indicate that the presence of neuroendocrine differentiation cannot be recommended as a prognostic marker in colorectal carcinomas.
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Pooja Kundapur
authors.initials: PK
authors.lastname: Suresh
authors.affiliation: Additional Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Kausalya Kumari
authors.initials: KK
authors.lastname: Sahu
authors.affiliation: Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Radha Ramachandra
authors.initials: RR
authors.lastname: Pai
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Hanaganahalli Basaviah
authors.initials: HB
authors.lastname: Sridevi
authors.affiliation: Assistant Professor, Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Kirthinath
authors.initials: K
authors.lastname: Ballal
authors.affiliation: Senior, Resident, Department of Pathology, Deen Dayal Upadhyay Hospital , New Delhi, India .
authors.forename: Binit
authors.initials: B
authors.lastname: Khandelia
authors.affiliation: Assistant Professor, Department of Pathology, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Jessica
authors.initials: J
authors.lastname: Minal
authors.affiliation: Assistant Professor, Department of Orthopedics, Kasturba Medical College, Manipal University , Mangalore, India .
authors.forename: Rajendra
authors.initials: R
authors.lastname: Annappa
keywords: Carcinoma of colon; Chromogranin; Prognostic marker; Synaptophysin
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