Neuroendocrine differentiation in stage D2 prostate cancers
Neuroendocrine differentiation in stage D2 prostate cancers
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DOI：
10.1111/j.1442-2042.2008.02015.x
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发表时间：
2008-05-01
影响因子：
2.6
通讯作者：
Ichikawa, Tomohiko
中科院分区：
文献类型：
--
作者：
Kamiya, Naoto;Suzuki, Hiroyoshi;Ichikawa, Tomohiko
目的：嗜铬粒蛋白A （CgA）和神经特异性烯醇化酶（NSE）作为几种类型神经内分泌肿瘤的标志物正逐渐被接受，CgA和NSE的浓度升高与前列腺癌的神经内分泌分化有关。本研究旨在探讨未经治疗的D-2期前列腺癌患者免疫组化（IHC）结果与血清CgA和NSE值之间的相关性。方法：对58例前列腺癌患者进行CgA和NSE抗体免疫组化，对18例经雄激素消融术治疗的D-2期前列腺癌患者进行血清CgA和NSE水平的单克隆免疫放射测定。我们研究了前列腺癌患者CgA和NSE的预处理血清水平、免疫组化结果与临床病理参数和预后的关系。此外，我们还评估了免疫组化结果与血清CgA和NSE水平的相关性。结果：CgA阳性与血清CgA水平相关性有统计学意义（P = 0.0421）。NSE阳性与血清NSE水平无统计学意义（P < 0.05）。我们根据CgA和NSE的IHC阳性将D-2期患者分为三组。单独CgA和联合CgA合并NSE的强阳性（++）患者的病因特异性生存率明显较差（P = 0.0379）。D-2期前列腺癌患者病因特异性生存率的多因素分析表明，强免疫组化染色被认为是与死亡风险增加相关的自变量（P = 0.0142）。结论：D-2期前列腺癌的神经内分泌分化作为一种潜在的发现预后引起了广泛关注。因此，与NSE相比，CgA在血清水平和免疫组化阳性之间具有更强的相关性，提示CgA作为预测前列腺癌神经内分泌分化程度的肿瘤标志物具有临床价值。
Objectives: 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).Conclusion: 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.