Background/Aim: To compare serum chromogranin A (CgA) and insulin-like growth factor 1 (IGF-1) with the classical prostate-specific antigen (PSA) marker in clinically localized prostate adenocarcinomas. Materials and Methods: This is a prospective single-center study that included 64 consecutive men with newly diagnosed clinically localized prostate adenocarcinoma and 20 consecutive men with histologically confirmed benign prostatic hyperplasia (BPH). A blood sample for the determination of serum total PSA, CgA and IGF-1 levels (RIA) was obtained from all cases. Analysis of variance was performed to evaluate their variations according to disease and the pathological characteristics of prostate adenocarcinoma. Results: Only serum PSA levels (p < 0.0001) and not IGF-1 (p = 0.5475) or CgA (p = 0.5043) were significantly higher in the prostate cancer (PCa) group as compared to the BPH group. A significant variance between BPH and PCa divided on the basis of pT stage was found for PSA levels (p < 0.0001) but not for CgA (p = 0.0869) and IGF-1 (p = 0.6883) levels. Dividing PCa on the basis of Gleason score, a significant variance was found for CgA (p = 0.0100) and for PSA (p < 0.001), but not for IGF-1 (p = 0.6895) levels. Conclusions: In our population the quantification of PSA and CgA serum levels and not of IGF-1 provides independent significant information in the diagnosis and aggressiveness of PCa, respectively.

This study evaluated perioperative and postoperative variations in serum CgA levels induced by radical retropubic prostatectomy (RRP) and their relationship with serum PSA levels in prostate cancer patients. Thirty consecutive patients with clinically localized adenocarcinoma of the prostate undergoing RRP were prospectively analyzed. Serum levels of CgA and total PSA were analyzed in each case preoperatively (time 0), at removal of the prostate (time 1), 1 h after the end of RRP (time 2) and then at regular postoperative intervals till 12 weeks (time 14). During the postoperative period no adjuvant therapies were performed and none of the 30 cases showed biochemical (PSA > 0.2 ng=mL) and=or clinical progression. Mean preoperative serum levels of CgA were 57 AE 14 ng=mL. Immediately after the surgical removal of the prostate gland (time 1), in all 30 cases there was a significant (time 0-time 1: p ¼ .001) increase in serum PSA, but a nonsignificant modification in serum CgA levels (60 AE 15 ng=mL). After time 1, serum PSA levels progressively decreased to below the detection limit of 0.2 ng=mL. On the contrary, at time 2, serum CgA levels were postoperatively increased (time 2 ¼ 145 AE 47) and they remained significantly higher than preoperative values (time 0) till the 21-day postoperative interval (time 11). Moreover, at the last control (time 14) mean and median CgA levels were very similar to those shown preoperatively (time 14: 58 AE 18 ng=mL). In patients with untreated clinically localized adenocarcinoma of the prostate submitted to RRP, surgical and postoperative stress, more than surgical manipulation of the prostate gland, could produce a significant increase in serum CgA levels maintained for a longer period when compared to the increase in serum PSA levels.

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