Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.)-IRCCS, Via Piero Maroncelli 40, 47014 Meldola, FC, Italy.
Centro di Riferimento Oncologico della Basilicata IRCCS, Rionero in Vulture, Italy.
Crit Rev Oncol Hematol. 2014 Oct;92(1):11-24. doi: 10.1016/j.critrevonc.2014.05.008. Epub 2014 May 27.
Neuroendocrine differentiation (NED) secondary to androgen deprivation therapy (ADT) may be frequent in various stages of prostate cancer (PC), particularly in castration-resistant PC (CRPC). NED generally involves more aggressive PC clinical behavior and an unfavorable prognosis. The identification of neuropeptides secreted by NE cells and of different proliferative and anti-apoptotic pathways has led to attention being focused on probable diagnostic targets and therapeutic options for a subtype of PC. Emerging evidence suggests that the acquisition of epithelial-mesenchymal transition (EMT) and cancer stem cell (CSC) phenotype are associated with the development of NED in PC, responsible for a complex interaction between ADT, the onset of CRPC and NED, in which EMT and CSC could play a central role, providing potential therapeutic targets. In this article, we review the pathogenetic, prognostic and predictive significance of NED in human PC, providing an insight into innovative agents capable of treating and perhaps preventing NED occurrence.
神经内分泌分化（NED）继发于雄激素剥夺治疗（ADT）可能在前列腺癌（PC）的各个阶段都很常见，特别是在去势抵抗性 PC（CRPC）中。NED 通常涉及更具侵袭性的 PC 临床行为和不利的预后。NE 细胞分泌的神经肽和不同的增殖和抗凋亡途径的鉴定，导致人们关注可能的诊断靶点和治疗选择的 PC 亚型。新出现的证据表明，上皮-间充质转化（EMT）和癌症干细胞（CSC）表型的获得与 PC 中 NED 的发展有关，这与 ADT、CRPC 和 NED 的发生之间的复杂相互作用有关，在这种相互作用中，EMT 和 CSC 可能发挥核心作用，为提供潜在的治疗靶点。在本文中，我们综述了 NED 在人 PC 中的发病机制、预后和预测意义，为治疗和预防 NED 发生的创新药物提供了深入了解。
