Rodríguez-Zarco E, Vallejo-Benítez A, Umbría-Jiménez S, Pereira-Gallardo S, Pabón-Carrasco S, Azueta A, González-Cámpora R, Espinal P S, García-Escudero A
Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España.
Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España.
Actas Urol Esp. 2017 Oct;41(8):529-534. doi: 10.1016/j.acuro.2016.11.009. Epub 2017 Mar 9.
Prostatic small-cell neuroendocrine carcinoma is an uncommon malignancy that constitutes 0.5-1% of all prostate malignancies. The median cancer-specific survival of patients with prostatic small-cell neuroendocrine carcinoma is 19 months, and 60.5% of the patients have metastatic disease. Neural development transcription factors are molecules involved in the organogenesis of the central nervous system and of neuroendocrine precursors of various tissues, including the suprarenal gland, thyroid glands, lungs and prostate.
We present 3 cases of this uncommon condition, applying the new World Health Organisation criteria. We conducted studies through haematoxylin and eosin staining and analysed the expression of the neural development transcription factors achaete-scute homolog like 1, thyroid transcription factor 1 and the class III/IV POU transcription factors, as a new research line in the carcinogenesis of prostatic neuroendocrine tumours.
In case 1, there was no TTF1 immunoexpression. Cases 2 and 3 had positive immunostaining for ASCL1, and Case 1 had negative immunostaining. BRN2 immunostaining was negative in case 1 and positive in cases 2 and 3.
The World Health Organisation does not recognise any molecular or genetic marker with prognostic value. ASCL-1 is related to the NOTCH and WNT signalling pathways. ASCL-1, TTF1 and BRN2 could be used for early diagnosis and as prognostic factors and therapeutic targets.
前列腺小细胞神经内分泌癌是一种罕见的恶性肿瘤，占所有前列腺恶性肿瘤的0.5 - 1%。前列腺小细胞神经内分泌癌患者的癌症特异性生存中位数为19个月，60.5%的患者有转移性疾病。神经发育转录因子是参与中枢神经系统以及包括肾上腺、甲状腺、肺和前列腺在内的各种组织的神经内分泌前体器官发生的分子。
我们应用世界卫生组织的新标准，报告了3例这种罕见疾病。我们通过苏木精和伊红染色进行研究，并分析神经发育转录因子achaete - scute同源物样1、甲状腺转录因子1和III/IV类POU转录因子的表达，作为前列腺神经内分泌肿瘤致癌作用研究的新方向。
病例1中，未发现TTF1免疫表达。病例2和病例3对ASCL1免疫染色呈阳性，病例1免疫染色呈阴性。病例1中BRN2免疫染色呈阴性，病例2和病例3呈阳性。
世界卫生组织未认可任何具有预后价值的分子或遗传标志物。ASCL - 1与NOTCH和WNT信号通路相关。ASCL - 1、TTF1和BRN2可用于早期诊断，并作为预后因素和治疗靶点。
