Cohen M K, Arber D A, Coffield K S, Keegan G T, McClintock J, Speights V O
Scott & White Clinic and Memorial Hospital, Temple, TX 76508.
Cancer. 1994 Oct 1;74(7):1899-903. doi: 10.1002/1097-0142(19941001)74:7<1899::aid-cncr2820740712>3.0.co;2-u.
Neuroendocrine differentiation has been demonstrated by immunohistochemical preparations in many cases of acinar type prostatic adenocarcinoma (CAP). Some studies have suggested that this differentiation may indicate an adverse prognosis.
Tissue samples from 38 consecutive patients with clinical Stage II (AJCC) CAP who underwent radical retropubic prostatectomy (RRP) were studied after preparations were made with antichromogranin (ChA) and neuron-specific enolase (NSE). All patients were followed for at least 4 years post-RRP or until disease progression was documented by rising serum prostate specific antigen concentration, X-ray evidence of recurrence, or a positive tissue biopsy.
Nine of the 38 RRP specimens (24%) were positive for NSE, and 11 (29%) were positive for ChA. Neither of these neuroendocrine markers showed a significant correlation with tumor progression. Neuroendocrine differentiation in needle biopsy specimens from these same patients (when available) did not correlate with tumor progression either. Of the patients with tumor progression, 9 of 11 (82%) had pathologic Stage III disease after RRP; of those with no progression of CAP, only 7 of 27 (26%) had pathologic Stage III disease.
Neuroendocrine differentiation, as demonstrated by NSE and ChA preparations, was not helpful in predicting tumor progression of CAP.
免疫组织化学检测已证实在许多腺泡型前列腺癌（CAP）病例中存在神经内分泌分化。一些研究表明这种分化可能预示不良预后。
对38例连续的临床II期（美国癌症联合委员会[AJCC]分期）CAP患者的组织样本进行研究，这些患者均接受了耻骨后根治性前列腺切除术（RRP），术后采用抗嗜铬粒蛋白（ChA）和神经元特异性烯醇化酶（NSE）进行检测。所有患者在RRP术后至少随访4年，或直至血清前列腺特异性抗原浓度升高、X线复发证据或组织活检阳性记录到疾病进展。
38份RRP标本中有9份（24%）NSE呈阳性，11份（29%）ChA呈阳性。这两种神经内分泌标志物均与肿瘤进展无显著相关性。同样这些患者穿刺活检标本中的神经内分泌分化（如有）也与肿瘤进展无关。在肿瘤进展的患者中，RRP术后11例中有9例（82%）为病理III期疾病；在CAP无进展的患者中，27例中只有7例（26%）为病理III期疾病。
NSE和ChA检测所证实的神经内分泌分化无助于预测CAP的肿瘤进展。
