Neuroendocrine differentiation in carcinomas of the prostate: Do neuroendocrine serum markers reflect immunohistochemical findings?

Abstract

ABSTRACT:The aim of the present study was to examine the correlation between the immunohistochemical findings and the serum markers for neuroendocrine (NE) cells in patients with carcinoma of the prostate. Preoperative serum values of chromogranin A (CgA), chromogranin B (CgB), pancreastatin (Pst), neuron-specific enolase (NSE), and prostatic specific antigen (PSA) were determined in 22 patients. The tissue specimens were obtained by a palliative transurethral resection of the prostate (TURP) because of urinary outflow obstruction. Immunohistochemistry was performed by using antibodies against CgA, CgB, NSE, serotonin, thyroid-stimulating hormone (TSH), and somatostatin. Tumor cells with NE differentiation were found in 91% of the cases. No patient had elevated serum values of NSE, despite the presence of NSE-positive tumor cells in 77% of the tumors. Neither did CgB in serum correlate with the immunohistochemical findings. Elevated serum values of CgA were found in 59% of patients. A positive correlation between the number of CgA-staining cells and the serum values of CgA was found, as seven out of eight patients with groups of CgA-positive tumor cells had elevated serum values of CgA. We conclude that CgA, in contrast to NSE, CgB, and Pst, seems to be a useful serum marker in predicting the extent of NE differentiation in prostatic tumors.

The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia

“…Elevated plasma CgB was found in five of 63 patients with hepatoma, four of eight patients with pancreatic adenocarcinoma 45 and three of 22 patients with prostate carcinoma. 112 Elevated plasma CART (>150 pmol/L) has been described in patients with pancreatic, bowel and prostate cancer. 46 Histological studies have identified CgA-immunoreactivity and CgB-immunoreactivity in prostate carcinoma.…”

“…106,107 Using different CgA assays, elevated circulating CgA has been detected in patients with carcinoma of the pancreas, liver, ovary, prostate, colon and breast and colon. 103,105,[108][109][110][111][112][113] When metastatic non-NEN CgA concentrations were compared with non-metastatic non-NEN CgA concentrations, no significant difference was found. 82 Although circulating CgA is elevated in some non-NEN tumours, it is unlikely that CgA is more sensitive than traditionally used biomarkers.…”

Clinical implications of neuroendocrine differentiation in prostate cancer

“…Although NE cells are typically thought to be post-mitotic, 5 at least one paper claims otherwise. 92 Modern chemotherapy regimens may be useful according to a recent report, 35 which demonstrated significant decreases in CgA in treated AI CaP patients.…”

Hormone-refractory prostate cancer: a multi-step and multi-event process

“…87 In fact, the overall abundance of NE cells has been reported to increase with progression of prostate cancer to advanced or hormone-resistant states. 88 Furthermore, comparisons of hormone-dependent and clinically advanced, hormone-independent prostate cancers found an increased of serum levels of chromogranin A 89 and NSE, 90 which are markers for NE cells.…”