Neuroendocrine differentiation is not prognostic of failure after radical prostatectomy but correlates with tumor volume
Neuroendocrine differentiation is not prognostic of failure after radical prostatectomy but correlates with tumor volume
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DOI：
10.1016/s0090-4295(00)00838-4
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发表时间：
2000-12-01
期刊：
影响因子：
2.1
通讯作者：
Abrahamsson, PA
中科院分区：
文献类型：
--
作者：
Ahlgren, G;Pedersen, K;Abrahamsson, PA
目标。目的研究前列腺癌神经内分泌(NE)肿瘤细胞分化与前列腺癌根治术后失败的关系。111例前列腺癌根治术患者中，103例随机分为新辅助黄体生成素类似物治疗组(新辅助组)和单纯手术组(对照组)。使用嗜铬粒蛋白A(CGA)抗体的免疫组织化学方法能够检测具有NE分化的肿瘤细胞。NE分化分为NE阴性(0~1+)或NE阳性(2~3+)。在另一项分析中评估了载玻片上CgA阳性细胞数/cm(2)肿瘤面积。术后随访39个月，连续两次血样前列腺特异性抗原值大于或等于0.5 ng/m L被认为是生化不合格。对新辅助激素治疗进行分层的Kaplan-Meier分析显示，NE阳性肿瘤患者的失败率明显高于NE阴性肿瘤患者。然而，CgA阳性细胞数/cm(2)不是一个有预后意义的变量。相反，NE分化和CgA阳性细胞计数均与切片上的肿瘤面积相关(P=0.0001)。多因素分析显示载玻片上的肿瘤面积(P
Objectives. To study neuroendocrine (NE) tumor cell differentiation in prostate cancer in relation to failure after radical prostatectomy.Methods. Radical prostatectomy specimens from 103 of 111 patients randomized to 3-month neoadjuvant luteinizing hormone-releasing hormone-analogue treatment (neoadjuvant group) or to surgery alone (control group) were available for analysis. Immunohistochemistry using antibodies to chromogranin A (CGA) enabled detection of tumor cells with NE differentiation. NE differentiation was scored as NE-negative (0 to 1+) or NE-positive (2 to 3+). The number of CGA-positive cells/cm(2) tumor area on the slides was assessed in a separate analysis. The patients were followed up for 39 months after surgery, and a prostate-specific antigen value of 0.5 ng/mL or greater in two consecutive blood samples was considered biochemical failure.Results. Kaplan-Meier analysis stratified for neoadjuvant hormonal treatment showed the failure rate to be significantly greater among those with NE-positive tumors than among those with NE-negative tumors. However, the number of CGA-positive cells/cm(2) was not a variable of prognostic significance. Instead, both NE differentiation and the CGA-positive cell count correlated with the tumor area on the slides (P = 0.0001). Multivariate analysis revealed the tumor area on the slide (P