Krijnen J L, Bogdanowicz J F, Seldenrijk C A, Mulder P G, van der Kwast T H
Department of Pathology, Erasmus University, Rotterdam, The Netherlands.
J Urol. 1997 Jul;158(1):171-4. doi: 10.1097/00005392-199707000-00054.
We evaluated the prognostic impact of neuroendocrine differentiation in prostate cancer with regard to the onset of endocrine therapy failure.
A retrospective study was performed on 72 transurethral resection specimens from patients who subsequently underwent endocrine therapy for prostate cancer and were followed for 44 to 95 months. Progression-free interval was recorded. Distribution pattern and proportion of neuroendocrine cells were examined in transurethral resection specimens. Neuroendocrine cells were identified based on immunoreactivity for chromogranin A.
Of 32 patients with progressive disease 27 died of prostate cancer. Chromogranin A positive cells were found in 40 of the 72 prostate cancers (55%). In a Cox proportional hazards analysis neuroendocrine differentiation of the tumor showed a negative correlation with progression-free survival (p = 0.022), which proved to be independent of the Gleason score (p < 0.001).
Our results support the view that neuroendocrine differentiation in prostatic adenocarcinomas is a prognostic factor for progressive disease under subsequent endocrine therapy. This prognosticator acts independently of tumor grade.
我们评估了神经内分泌分化对前列腺癌内分泌治疗失败起始的预后影响。
对72例经尿道前列腺切除术标本进行回顾性研究，这些患者随后接受了前列腺癌内分泌治疗，并随访44至95个月。记录无进展生存期。在经尿道前列腺切除术标本中检查神经内分泌细胞的分布模式和比例。基于嗜铬粒蛋白A的免疫反应性鉴定神经内分泌细胞。
32例疾病进展患者中，27例死于前列腺癌。72例前列腺癌中有40例（55%）发现嗜铬粒蛋白A阳性细胞。在Cox比例风险分析中，肿瘤的神经内分泌分化与无进展生存期呈负相关（p = 0.022），这被证明独立于Gleason评分（p < 0.001）。
我们的结果支持以下观点，即前列腺腺癌中的神经内分泌分化是后续内分泌治疗下疾病进展的一个预后因素。该预后指标独立于肿瘤分级起作用。
