Zissimopoulos Athanasios, Bantis Athanasios, Sountoulides Petros, Giannakopoulos Stelios, Kalaitzis Christos, Agelonidou Eleni, Touloupidis Stavros
Nuclear Medicine Department, School of Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Hell J Nucl Med. 2009 Sep-Dec;12(3):234-7.
Prostate adenocarcinomas (PAC) consist mainly of tumour cells of luminal immunophenotype and scattered neuroendocrine (NE) cells. NE cells are defined by chromogranin A (CgA) immunoreactivity. T he aim of this study is the evaluation of CgA serum levels in monitoring prostate cancer (PC) patients under complete androgen deprivation (CAD) in comparison with the prostate specific antigen (PSA) as a prognostic marker of androgen resistance and bone metastases. Ninety-two patients with newly diagnosed PAC and 30 healthy blood donors serving as the control group were enrolled in the study. Serum CgA and PSA values were measured. All patients had locally advanced or metastatic disease and received CAD treatment. In the group of PAC patients bone scanning with 925MBq (99m)Tc-MDP revealed the presence of bone metastatic lesions in 50 patients (29 with more than 3 lesions and 21 with less than 3 lesions). The other 42 patients had no bone metastases. The patients and the control group were re-evaluated after 1 year. Our results showed that serum CgA positively correlated with multiple bone metastases and higher Gleason score, serum levels of CgA and PSA. Levels of PSA were significantly higher in patients with PAC and bone metastases compared with those with no bone metastases (P<0.001). In patients with multiple bone metastases and Gleason Score >7 elevated serum levels of CgA higher than those of PSA were found. In conclusion, serum CgA levels is a valuable marker for predicting the presence of multiple bone metastases in PAC patients. Combined with PSA, CgA can predict disease progression in patients with advanced PAC under CAND treatment and is correlated with poor prognosis.
前列腺腺癌（PAC）主要由具有管腔免疫表型的肿瘤细胞和散在的神经内分泌（NE）细胞组成。NE细胞通过嗜铬粒蛋白A（CgA）免疫反应性来定义。本研究的目的是评估在完全雄激素剥夺（CAD）情况下，CgA血清水平在监测前列腺癌（PC）患者中的作用，并与作为雄激素抵抗和骨转移预后标志物的前列腺特异性抗原（PSA）进行比较。92例新诊断的PAC患者和30名健康献血者作为对照组纳入本研究。检测血清CgA和PSA值。所有患者均患有局部晚期或转移性疾病并接受CAD治疗。在PAC患者组中，用925MBq（99m）Tc-MDP进行骨扫描发现50例患者存在骨转移病灶（29例有3个以上病灶，21例有少于3个病灶）。其他42例患者无骨转移。1年后对患者和对照组进行重新评估。我们的结果显示，血清CgA与多发骨转移和更高的Gleason评分、CgA和PSA血清水平呈正相关。与无骨转移的患者相比，PAC和骨转移患者的PSA水平显著更高（P<0.001）。在多发骨转移且Gleason评分>7的患者中，发现血清CgA水平高于PSA水平。总之，血清CgA水平是预测PAC患者多发骨转移存在的有价值标志物。与PSA联合使用时，CgA可预测接受CAND治疗的晚期PAC患者的疾病进展，且与不良预后相关。
