Wu J T, Astill M E, Liu G H, Stephenson R A
Department of Pathology, University of Utah Health Science Complex, Salt Lake City 84132, USA.
J Clin Lab Anal. 1998;12(1):20-5. doi: 10.1002/(sici)1098-2825(1998)12:1<20::aid-jcla4>3.0.co;2-n.
We monitored both chromogranin A (CgA) and neuron specific enolase (NSE) in serial serum specimens from 14 patients with prostate cancer (CAP patients) showing resistance to hormonal treatment. Elevated serum CgA was detected in 10 out of these 14 patients (71%) during treatment, and an early appearance of elevated serum CgA was found in 6 of 14 (43%) of these patients when serum tPSA levels were still in the normal range. If patients with radical prostatectomy were not included, the percentage of patients showing an early appearance of elevated serum CgA would have been much higher. Elevated serum CgA levels also were found in patients not subject to hormonal therapy. Serial specimens from two out of three prostate cancer patients, randomly selected, contained elevated serum CgA. Serum NSE was not detectable in any of the serial specimens we studied, suggesting that CgA, not NSE, should be used as a marker for neuroendocrine differentiation. We also compared the serum CgA in random serum specimens between patients with BPH (benign prostate hyperplasia) and with prostate cancer in the concentration range of serum tPSA between 3-15 ng/mL. Although serum CgA concentrations in BPH patients overlapped considerably with those levels in patients with prostate cancer, levels > 100 ng/mL should suggest prostate cancer. The early appearance of elevated serum CgA allows an early change of therapy to be made and can lead to the effective prevention of any further development of metastases.
我们监测了14例对激素治疗耐药的前列腺癌患者（CAP患者）系列血清样本中的嗜铬粒蛋白A（CgA）和神经元特异性烯醇化酶（NSE）。在这14例患者中，10例（71%）在治疗期间检测到血清CgA升高，其中6例（43%）在血清总前列腺特异抗原（tPSA）水平仍在正常范围时就出现了血清CgA升高。如果不包括接受根治性前列腺切除术的患者，血清CgA早期升高患者的比例会更高。未接受激素治疗的患者中也发现血清CgA水平升高。随机选取的3例前列腺癌患者中的2例系列样本中血清CgA升高。在我们研究的任何系列样本中均未检测到血清NSE，这表明应将CgA而非NSE用作神经内分泌分化的标志物。我们还比较了良性前列腺增生（BPH）患者和前列腺癌患者在血清tPSA浓度范围为3 - 15 ng/mL时随机血清样本中的血清CgA。尽管BPH患者的血清CgA浓度与前列腺癌患者的浓度有相当大的重叠，但>100 ng/mL的水平应提示前列腺癌。血清CgA升高的早期出现使得能够早期改变治疗方案，并可有效预防转移的进一步发展。
