Deftos L J, Nakada S, Burton D W, di Sant'Agnese P A, Cockett A T, Abrahamsson P A
Department of Medicine, University of California, USA.
Urology. 1996 Jul;48(1):58-62. doi: 10.1016/s0090-4295(96)00089-1.
Neuroendocrine differentiation in carcinoma of the prostate is characterized by the expression of neuroendocrine cell products such as chromogranin A (CgA). We studied serum levels and tissue staining for CgA in prostate cancer to assess their clinical value.
In 82 patients with prostate cancer, serum specimens were obtained at diagnosis and studied by both CgA and prostate-specific antigen (PSA) immunoassays. In 43 additional patients with prostate cancer, paraffin-embedded tissue from core biopsies or transurethral resections and serum samples were studied, respectively, by immunohistology and immunoassay for CgA.
In serum samples from the 82 patients in whom CgA and PSA levels were measured, 26 of 82 (32%) had an elevated CgA (greater than 200 ng/mL), and 36 of 82 (44%) had an elevated PSA (greater than 4.0 ng/mL). Of the patients with Stage D2 cancer, 11 of 18 (61%) had an elevated CgA and 6 of 18 (33%) had an elevated PSA. Four of 5 patients with local recurrence had an elevated CgA, but only 1 patient had an elevated PSA. Of the 43 patients in whom serum and tissue CgA studies were performed, 12 (28%) had elevated serum CgA, and 15 of the 43 (35%) had CgA staining in their prostate tissue. Of the 14 of these patients with D2 disease (distant metastases), 9 (64%) had elevated serum levels of CgA and 6 (43%) had positive staining in their prostate tissue. Of the 9 patients with Stage D2 disease and elevated serum CgA, 6 had a normal serum PSA.
Our studies complement those of others and indicate that CgA has potential as a clinically useful serum and tumor marker for prostate cancer. Serum CgA measurements can identify some patients with advanced disease who do not have elevated serum PSA. However, further studies in larger groups of patients are needed to define the clinical value of CgA as a marker for prostate cancer.
前列腺癌中的神经内分泌分化以神经内分泌细胞产物如嗜铬粒蛋白A（CgA）的表达为特征。我们研究了前列腺癌患者血清中CgA的水平及组织染色情况，以评估其临床价值。
在82例前列腺癌患者中，诊断时采集血清标本，采用CgA和前列腺特异性抗原（PSA）免疫测定法进行检测。另外43例前列腺癌患者，分别对其经皮穿刺活检或经尿道前列腺切除术获得的石蜡包埋组织及血清样本进行CgA免疫组织化学和免疫测定研究。
在测定了CgA和PSA水平的82例患者的血清样本中，82例中有26例（32%）CgA升高（大于200 ng/mL），82例中有36例（44%）PSA升高（大于4.0 ng/mL）。在D2期癌症患者中，18例中有11例（61%）CgA升高，1十八例中有6例（33%）PSA升高。5例局部复发患者中有4例CgA升高，但只有1例PSA升高。在进行血清和组织CgA研究的43例患者中，12例（28%）血清CgA升高，43例中有15例（35%）前列腺组织CgA染色阳性。在这些患有D2期疾病（远处转移）的14例患者中，9例（64%）血清CgA升高，6例（43%）前列腺组织染色阳性。在9例D2期疾病且血清CgA升高的患者中，6例血清PSA正常。
我们的研究补充了其他研究的结果，表明CgA有可能作为一种对前列腺癌临床有用的血清和肿瘤标志物。血清CgA检测可识别一些血清PSA未升高的晚期疾病患者。然而，需要对更多患者群体进行进一步研究，以明确CgA作为前列腺癌标志物的临床价值。
