The occurrence and clinicopathological significance of serotonin immunoreactive cells in large bowel carcinoma

Abstract

We studied the incidence, clinicopathological relevance and prognostic significance of serotonin immunoreactive cells in a clinically well-documented series of 300 large bowel cancer patients. Serotonin immunoreactive cells were detected in 8 per cent of the carcinomas, occurring either as focal clusters (4.7 per cent) or as occasional single cells (3.3 per cent). Both types frequently displayed presence of mucin and/or immunoreactivity for secretory component as well. In respect of localization, stage or tumour extension and histological grade tumours with serotonin immunoreactivity showed no significant differences in comparison with carcinomas lacking this feature. In terms of survival, however, the tumours with serotonin immunoreactivity demonstrated a more aggressive clinical course in comparison with tumours without these cells. This phenomenon reached borderline statistical significance. It is therefore concluded that the study of serotonin immunoreactivity in large bowel carcinomas enables the identification of a subpopulation of colorectal carcinomas with a relatively poor prognosis.

The prevalence and clinical significance of chromogranin A and secretogranin II immunoreactivity in colorectal adenocarcinomas

“…Smith and Hagitt [34] evaluated a series of colorectal adenocarcinomas applying the Churukian-Schenk stain for demonstrating argyrophil cells and concluded that the presence of endocrine differentiation was not associated with a worse prognosis. A few investigators have demonstrated the presence of serotonin and chromogranin A immunoreactive cells in colorectal carcinomas and assessed the clinical implications of endocrine differentiation in these tumours [1,9,15]. The clinical significance of these observations was variable; Arends et al [1] reported that serotonin expression was present in tumours with a slightly worse prognosis, with borderline statistical significance, whereas Hamada etal.…”

“…A few investigators have demonstrated the presence of serotonin and chromogranin A immunoreactive cells in colorectal carcinomas and assessed the clinical implications of endocrine differentiation in these tumours [1,9,15]. The clinical significance of these observations was variable; Arends et al [1] reported that serotonin expression was present in tumours with a slightly worse prognosis, with borderline statistical significance, whereas Hamada etal. [15] and de Bruine et al [9] reported that the presence of chromogranin A immunoreactivity was associated with a worse prognosis, statistically significant by univariate and multivariate analysis.…”

“…The presence of cells containing secretory granules of endocrine type in carcinomas arising in the gastrointestinal tract has been documented convincingly using argyrophil stains [2,18,23,32,36] and, more recently, by the immunocytochemical demonstration of the presence of specific endocrine markers [1,4,9,13,15,19,27,28]. The occurrence of endocrine cells in noncarcinoid carcinomas of the gastrointestinal tract, however, initially generated controversies about the origin of these cells.…”

Endocrine cells in colorectal adenocarcinomas: Incidence, hormone profile and prognostic relevance

“…Expression of the biogenic amine serotonin (5-HT) had been previously determined in the same series of patients (Arends et al 1986). Cross-tabulation between both studies showed that 5-HT immunoreactivity was present in 17 of 84 CGA positive cases (20%).…”

“…The matter of prognosis of colorectal adenocarcinomas containing endocrine cells has not yet been settled, because studies with reliable follow-up data are scarce, and the studies which have been performed have generated conflicting results. We have reported a tendency for poorer prognosis of adenocarcinomas with serotonin (5-HT) expression (Arends et al, 1986), contradicting some earlier reports, which denied any effect of endocrine differentiation on prognosis (Smith and Haggitt, 1984). The data on 5-HT expression in adenocarcinomas barely reached statistical significance, perhaps because the number of 5-HT-positive cases was too small, or the follow-up period too short for definite conclusions.…”