Association of neuroendocrine differentiation with neoadjuvant hormone therapy effects in prostatic cancer

Tokunaga, Masatoshi; Yasuda, Masanori; Osamura, R. Yoshiyuki; Itoh, Johbu; Mukai, Masaya; Shima, Masanori; Usui, Yukio; Masuda, Aiichiro; Miyakita, Hideshi; Terachi, Toshiro

doi:10.3892/or.13.6.1081

Cited by 2 publications

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“…Thirty‐three of these studies correlated the presence of neuroendocrine staining to patient outcomes such as biochemical recurrence, clinical progression, overall survival and prostate cancer‐specific survival. The characteristics of the included studies are summarized in Table 1 [19–80] and Table S2.…”

Section: Resultsmentioning

confidence: 99%

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

et al. 2021

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To perform a systematic review and meta-analysis of the literature to understand the variation in the reporting of neuroendocrine staining and determine the influence of reporting neuroendocrine staining at diagnosis on patient outcomes. MethodsMedical databases were searched to identify studies in which adenocarcinoma specimens were stained with any of the following four neuroendocrine markers: chromogranin A (CgA), neuron-specific enolase (NSE), synaptophysin and CD56. The prevalence of neuroendocrine staining and correlation of the prevalence of neuroendocrine staining to patient outcomes were analysed using a random-effects model. All statistical tests were two-sided. ResultsSixty-two studies spanning 7616 patients were analysed. The pooled prevalence for the most common marker, CgA (41%), was similar to that of NSE (39%) and higher than that of synaptophysin (31%). The prevalence of CgA staining was significantly influenced by reporting criteria, where objective thresholds reduced the variation in prevalence to 26%. No correlation was found between CgA prevalence and tumour grade. Patients positive for CgA staining using objective criteria had more rapid biochemical progression (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.49 to 2.65) and poorer prostate cancer-specific survival (HR 7.03, 95% CI 2.55 to 19.39) compared to negative patients, even among those with low-risk cancers. ConclusionDiscrepancies in the reported prevalence of neuroendocrine cells in adenocarcinoma are driven by the inconsistent scoring criteria. This study unequivocally demonstrates that when neuroendocrine cell staining is assessed with objective criteria it identifies patients with poor clinical outcomes. Future studies are needed to determine the exact quantifiable thresholds for use in reporting neuroendocrine cell staining to identify patients at higher risk of progression.

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Section: Resultsmentioning

confidence: 99%

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

et al. 2021

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“…Studies exploring neuroendocrine differentiation in prostate cancer suggested that CGA (marker of neuroendocrine differentiation) velocity has the potential to predict androgen‐independent progression after endocrine therapy [41]. Neuroendocrine differentiation was found to be negatively associated with the histological response of prostatic cancer to neoadjuvant hormone therapy [42]. Image analysis of androgen receptor immunostaining with a receptogram‐orientated approach was used to predict the response to hormone treatment in patients with metastatic prostate cancer, with PPV and negative PV values of 96.5% and 63%[22].…”

Section: Discussionmentioning

confidence: 99%

Changes in chromatin phenotype predict the response to hormonal deprivation therapy in patients with prostate cancer

et al. 2009

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OBJECTIVE To assess the value of studying chromatin organization using high‐resolution digital image analysis to predict the response to hormonal‐deprivation therapy (HDT) in patients with prostate cancer, using pretreatment prostate tissues. MATERIALS AND METHODS A tissue microarray (TMA) was constructed using pretreatment paraffin‐embedded tissues from transurethral resection of the prostate (TURP) samples (48 patients, 96 cores). None of the patients had received any treatment for prostate cancer before TURP. The patients’ medical records for 5 years after treatment were assessed; patients were divided, based on their prostatic specific antigen (PSA) levels after treatment, into those optimally responsive to HDT (14) and those resistant to HDT (34). The latter were further subclassified based on their nadir PSA level. Imaging comprised a calibrated digital image‐analysis system with software for densitometric and texture analysis, the latter being assessed on manually segmented nuclei (≥30 nuclei/core). RESULTS Most of the measured digital texture features assessing chromatin density and distribution were significantly different between the prognostic groups (P = 0.001). In the training set, 12 of 14 HDT‐responsive and 23 (68%) of HDT‐resistant patients were accurately predicted. However, all HDT‐resistant patients with a nadir PSA level of >5 ng/mL were accurately predicted. The overall classification sensitivity was 47%, specificity 94% with a positive predictive value of 85%. However, the sensitivity was 100% between patients optimally responsive to HDT and those poorly responsive with a nadir PSA level of >5 ng/mL. CONCLUSION Quantitative image analysis of chromatin phenotype showed promising value in predicting before treatment the response to HDT in patients diagnosed with prostatic adenocarcinoma. However, further work using larger data sets is required before adapting the technique in routine clinical practice.

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Association of neuroendocrine differentiation with neoadjuvant hormone therapy effects in prostatic cancer

Cited by 2 publications

References 0 publications

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

Changes in chromatin phenotype predict the response to hormonal deprivation therapy in patients with prostate cancer

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