Ferrero S, Buffa R, Pruneri G, Siccardi A G, Pelagi M, Lee A K, Coggi G, Bosari S
Department of Anatomic Pathology (II), IRCCS Ospedale Maggiore, Milan, Italy.
Virchows Arch. 1995;426(6):587-92. doi: 10.1007/BF00192113.
Colorectal adenocarcinomas may display features of endocrine differentiation, shown by argyrophil stains and by the expression of endocrine markers such as chromogranin A. We investigated chromogranin A and secretogranin II immunoreactivity in a series of 208 carcinomas of the large bowel to assess the prevalence and clinical significance of endocrine differentiation. Tumors expressing endocrine markers were classified as low expressors (< than 1 immunoreactive tumour cell/mm2) and high expressors (> than 1 immunoreactive tumour cell/mm2). There were 33 (16%) carcinomas showing both chromogranin A and secretogranin II immunoreactivity: 11 tumours (5%) were high expressors. Endocrine differentiation was not related to the disease stage, tumour location, grade, DNA ploidy and p53 protein accumulation. In the entire series chromogranin A immunoreactivity did not provide prognostic information using univariate and multivariate analysis. A worse overall survival (P = 0.048) was demonstrated for the stage III patients with high expressor tumours, but there were only five patients in this group. The results of our investigation suggest that chromogranin A immunoreactivity is not a useful variable in the prognostic assessment of colorectal adenocarcinomas.
结肠直肠癌可能表现出内分泌分化的特征，嗜银染色及嗜铬粒蛋白A等内分泌标志物的表达可证实这一点。我们研究了208例大肠癌中嗜铬粒蛋白A和分泌粒蛋白II的免疫反应性，以评估内分泌分化的发生率及临床意义。表达内分泌标志物的肿瘤被分为低表达者（<1个免疫反应性肿瘤细胞/mm2）和高表达者（>1个免疫反应性肿瘤细胞/mm2）。有33例（16%）癌同时显示嗜铬粒蛋白A和分泌粒蛋白II免疫反应性：11例肿瘤（5%）为高表达者。内分泌分化与疾病分期、肿瘤位置、分级、DNA倍体及p53蛋白积聚无关。在整个系列中，单因素和多因素分析显示嗜铬粒蛋白A免疫反应性未提供预后信息。III期高表达肿瘤患者的总生存期较差（P = 0.048），但该组仅有5例患者。我们的研究结果表明，嗜铬粒蛋白A免疫反应性在结肠直肠癌的预后评估中不是一个有用的变量。
