Department of Urology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China.
World J Surg Oncol. 2022 Dec 27;20(1):407. doi: 10.1186/s12957-022-02841-6.
Biomarkers of DNA damage repair deficiency provide opportunities for personalized treatment with immunotherapy. However, there is limited research on the immune microenvironment of adeno-neuroendocrine prostate cancer (NEPC). In this study, we aimed to assess and describe the comprehensive clinicopathological manifestations of NEPC to improve diagnosis and predict prognosis.
A retrospective medical record review of 66 patients with prostate cancer (PCa) was performed. PCa samples from the 66 patients were analyzed using immunohistochemical staining for the detection of chromogranin, neural cell adhesion molecule 1, and synaptophysin. For tumor-associated immune microenvironment analysis, PD-L1, CD3, and CD8 were labeled in tissue slides. The effect of clinicopathological factors on the survival of patients with Adeno-NEPC was analyzed.
Twenty patients presented with adeno-NEPC, whereas 46 presented with adeno-PCa. The median age of patients at PCa diagnosis was 67.86 ± 7.05 years (68.65 ± 7.23 years, adeno-NEPC; 67.52 ± 7.02 years, adeno-PCa). Eleven patients with adeno-NEPC underwent prostatectomy, whereas nine received primary androgen deprivation therapy (ADT). Additionally, 30 patients with adeno-PCa underwent prostatectomy, whereas 16 (34.8%) received primary ADT. There was a significant difference in overall survival between patients with adeno-NEPC and those with adeno-PCa (46.0 months vs. 65.0 months). There was also a significant difference in time from prostatectomy to biochemical recurrence between the groups of patients who underwent prostatectomy. Prostatectomy and normal lactate dehydrogenase levels were clinical factors that were significantly associated with better outcomes in patients with adeno-NEPC. Metastatic adeno-NEPC was associated with a higher programmed death ligand 1 (PD-L1) score (2-4) than localized PCa. The data showed that PD-L1 expression in adeno-NEPC may be negatively associated with that in CD8 T cells.
Our study revealed clinicopathological manifestations of adeno-NEPC and some possible predictive factors significantly associated with better outcomes in patients with adeno-NEPC. These findings might be beneficial in the development of diagnostic strategies and customized treatment plans.
DNA 损伤修复缺陷的生物标志物为免疫治疗的个体化治疗提供了机会。然而，关于腺神经内分泌前列腺癌（NEPC）的免疫微环境的研究有限。在这项研究中，我们旨在评估和描述 NEPC 的全面临床病理表现，以提高诊断和预测预后。
对 66 例前列腺癌（PCa）患者的病历进行回顾性医学记录审查。对 66 例 PCa 样本进行免疫组织化学染色，以检测嗜铬粒蛋白、神经细胞黏附分子 1 和突触素。为了分析肿瘤相关的免疫微环境，在组织切片中标记 PD-L1、CD3 和 CD8。分析临床病理因素对腺神经内分泌前列腺癌患者生存的影响。
20 例患者表现为腺神经内分泌前列腺癌，46 例患者表现为腺前列腺癌。PCa 诊断时患者的中位年龄为 67.86±7.05 岁（腺神经内分泌前列腺癌为 68.65±7.23 岁，腺前列腺癌为 67.52±7.02 岁）。11 例腺神经内分泌前列腺癌患者接受了前列腺切除术，9 例患者接受了原发性雄激素剥夺治疗（ADT）。此外，30 例腺前列腺癌患者接受了前列腺切除术，16 例（34.8%）患者接受了原发性 ADT。腺神经内分泌前列腺癌患者的总生存时间与腺前列腺癌患者有显著差异（46.0 个月 vs. 65.0 个月）。接受前列腺切除术的患者中，从前列腺切除术到生化复发的时间也有显著差异。前列腺切除术和正常乳酸脱氢酶水平是与腺神经内分泌前列腺癌患者预后较好相关的临床因素。转移性腺神经内分泌前列腺癌与局部前列腺癌相比，程序性死亡配体 1（PD-L1）评分（2-4）更高。数据显示，腺神经内分泌前列腺癌中 PD-L1 的表达可能与 CD8 T 细胞的表达呈负相关。
本研究揭示了腺神经内分泌前列腺癌的临床病理表现，以及一些可能与腺神经内分泌前列腺癌患者预后较好相关的预测因素。这些发现可能有助于制定诊断策略和定制治疗计划。
