Neuroendocrine serum tumour markers in hormone-resistant prostate cancer.

OBJECTIVE

The primary aim of the study was to assess the prevalence of elevated serum levels of neuron-specific enolase (NSE) and chromogranin A (CgA) in hormone-resistant prostate cancer (HRPC), and to evaluate these markers' prognostic significance. Secondarily we wanted to assess any change in serum levels of NSE or CgA after palliative radiotherapy.

METHODS

Serum samples from patients with painful bone metastases or symptomatic pelvic tumours due to HRPC were analyzed for prostate specific antigen (PSA), NSE and CgA before and after palliative radiotherapy.

RESULTS

Forty-six of 138 patients (33%) had elevated NSE before radiotherapy, while 80 (58%) had elevated CgA, without correlation between the two markers or with PSA. After radiotherapy the median NSE level was significantly reduced (p=0.004), whereas CgA (p=0.009) and PSA (p=0.019) increased. In the multivariate survival analysis, a reduced performance status, >20 bone metastases on bone scan, low hemoglobin, and pre-radiotherapy elevated NSE levels indicated a short survival.

CONCLUSION

Together with known clinical parameters, NSE predicts survival in patients with HRPC. NSE could become a valuable prognostic marker in patients with this condition.