Bollito E, Berruti A, Bellina M, Mosca A, Leonardo E, Tarabuzzi R, Cappia S, Ari M M, Tampellini M, Fontana D, Gubetta L, Angeli A, Dogliotti L
Dipartimento di Anatomia Patologica, Università di Torino, Orbassano, Italy.
Ann Oncol. 2001;12 Suppl 2:S159-64. doi: 10.1093/annonc/12.suppl_2.s159.
The biological behaviour of prostate cancer is highly variable and prediction by the commonly employed prognostic parameters is not sufficient. The concept of neuroendocrine (NE) differentiation in prostate adenocarcinoma has recently received increasing attention due to possible implications for prognosis and therapy.
Core needle biopsies from 142 newly diagnosed patients were immunohistochemically examined for the coexistence of NE differentiation using an antibody against chromogranin A (CgA). Circulating CgA was available in 106 of these patients.
NE differentiation was found in 64 (45.1%) tumors. Among them 29 (20.4%) had CgA positive cells scattered or focally distributed in less than 5% per mm3 of tumor tissues, 26 (18.3%) between 5% and 10% and 9 (6.4%) more than 10%, respectively. There was a significant correlation between the extent of NE features and either Gleason score (P < 0.01) or stage of disease. Circulating CgA but not PSA correlated with immunohistochemical CgA (P < 0.03) particularly in metastatic cases.
These data support the concept that NE differentiation in human prostate cancer has a negative prognostic significance. Circulating CgA levels reflect immunohistochemical findings.
前列腺癌的生物学行为高度可变，常用的预后参数对其进行预测并不充分。前列腺腺癌中神经内分泌（NE）分化的概念最近因对预后和治疗可能产生的影响而受到越来越多的关注。
对142例新诊断患者的粗针活检组织进行免疫组织化学检查，使用抗嗜铬粒蛋白A（CgA）抗体检测NE分化的共存情况。其中106例患者可检测循环CgA。
64例（45.1%）肿瘤发现有NE分化。其中，29例（20.4%）的CgA阳性细胞呈散在或局灶性分布，每立方毫米肿瘤组织中少于5%；26例（18.3%）在5%至10%之间；9例（6.4%）超过10%。NE特征的程度与Gleason评分（P < 0.01）或疾病分期之间存在显著相关性。循环CgA而非前列腺特异性抗原（PSA）与免疫组织化学CgA相关（P < 0.03），尤其是在转移病例中。
这些数据支持以下观点，即人类前列腺癌中的NE分化具有负面预后意义。循环CgA水平反映了免疫组织化学结果。
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