Herold Zoltan, Dank Magdolna, Herold Magdolna, Nagy Peter, Rosta Klara, Somogyi Aniko
Department of Internal Medicine and Oncology, Semmelweis University, Tomo u. 25-29., H-1083 Budapest, Hungary.
Department of Internal Medicine and Hematology, Semmelweis University, Szentkiralyi u. 46., H-1088 Budapest, Hungary.
Cancers (Basel). 2020 Dec 29;13(1):67. doi: 10.3390/cancers13010067.
Colorectal cancer (CRC) is known to be affected by paraneoplastic thrombocytosis and chromogranin A-positive neuroendocrine-cell differentiation (CgA). Their combined effect has never been previously investigated.
A prospective cohort pilot study of 42 CRC patients and 42 age- and sex-matched controls was carried out. Plasma interleukin-6, thrombopoietin, and serum chromogranin A and -B were measured; furthermore, tumor tissue was immunohistochemically stained for CgA.
Twenty-seven and 15 patients were assigned to the chromogranin A-negative (CgA) and CgA groups, respectively. Within the CgA group, right-sided tumors were more frequent (18.5% vs. 53.3%), no stage I cancer was found, and patients of this group were in worse general condition. Compared to control subjects, chromogranin A level was higher in the CgA group ( = 0.0086), thrombopoietin ( = 0.0040) and chromogranin B ( = 0.0070) in the CgA group, while interleukin-6 was high in both tumor groups ( ≤ 0.0090). Survival was significantly worse in the CgA group (hazard ratio: 5.73; = 0.0378).
Different thrombopoietin levels indicated distinct thrombocytosis types. Within the two CRC groups, serum levels of chromogranins changed in different directions suggesting two well-distinguishable pathophysiologies. Based on these observations we propose a new subtype of CRC, which can be characterized by chromogranin A-positive neuroendocrine-cell differentiation.
已知结直肠癌（CRC）会受到副肿瘤性血小板增多症和嗜铬粒蛋白A阳性神经内分泌细胞分化（CgA）的影响。此前从未对它们的联合作用进行过研究。
对42例CRC患者和42例年龄及性别匹配的对照进行了一项前瞻性队列试点研究。检测了血浆白细胞介素-6、血小板生成素以及血清嗜铬粒蛋白A和B；此外，对肿瘤组织进行了嗜铬粒蛋白A的免疫组织化学染色。
分别有27例和15例患者被归入嗜铬粒蛋白A阴性（CgA）组和CgA组。在CgA组中，右侧肿瘤更为常见（18.5%对53.3%），未发现I期癌症，且该组患者的一般状况较差。与对照受试者相比，CgA组的嗜铬粒蛋白A水平较高（=0.0086），CgA组的血小板生成素（=0.0040）和嗜铬粒蛋白B（=0.0070）较高，而两个肿瘤组的白细胞介素-6均较高（≤0.0090）。CgA组的生存率明显较差（风险比：5.73；=0.0378）。
不同的血小板生成素水平表明存在不同类型的血小板增多症。在两个CRC组中，嗜铬粒蛋白的血清水平变化方向不同，提示两种明显可区分的病理生理学。基于这些观察结果，我们提出了一种新的CRC亚型，其特征为嗜铬粒蛋白A阳性神经内分泌细胞分化。
