Significance of Neuroendocrine Cell Differentiation in Specimens from Patients with Prostate Cancer.
10.4111/kju.2008.49.7.585
- Author:
Chang Hoo PARK
1
;
Chang Myeon PARK
;
Han Kwon KIM
;
Kil Hyeon GANG
;
Jae Seok SONG
;
Jong Yeon PARK
Author Information
1. Departments of Urology, Gangneung Asan Hospital, College of Medicine, Ulsan University, Korea. jypark@gnah.co.kr
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Neuroendocrine differentiation;
Prognosis
- MeSH:
Antibodies, Monoclonal;
Chromogranin A;
Humans;
Logistic Models;
Lymph Node Excision;
Lymph Nodes;
Neoplasm Grading;
Neoplasm Metastasis;
Neuroendocrine Cells;
Neurotransmitter Agents;
Odds Ratio;
Prognosis;
Prostate;
Prostatectomy;
Prostatic Neoplasms
- From:Korean Journal of Urology
2008;49(7):585-591
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The neuroendocrine cell(NEC) is one of the constitutional cells found in the prostate gland; these cells secret neurotransmitters. These neuroendocrine products have been associated with prostate cancer progression. We evaluated the significance of neuroendocrine differentiation(NED) in radical prostatectomy specimens. MATERIALS AND METHODS: We studied 45 patients who underwent bilateral pelvic lymphadenectomy and radical prostatectomy. The patients were classified into three groups according to their pathological stage. Group A included cases with organ confined tumors, Group B local advanced tumors and Group C cases had any T stage and lymph node metastasis. The cellular expression of chromogranin A in matched samples from the same patients was evaluated by immunohistochemical staining using commercially available monoclonal antibodies. RESULTS: Sixteen(35.6%) tumors had chromogranin A stained cells. Chromogranin A immunoreactivity was greatest in cases with lymph node involvement(75.0%) compared to those with primary prostate cancer(5.9% in group A and 37.5% in group B). Pathologically advanced tumors or tumors with the highest histological grades were associated with increased NED. The median staining score was 0 in Group A, 0 in Group B and 1 in Group C. The logistic regression analysis the odds ratio for group C cases showed a relative risk of 32.07(95% CI: 2.783-369.416) for NED compared to Group A. An increased prostate-specific antigen(PSA) and Gleason score were also associated with the NED. CONCLUSIONS: The degree of NEC immunohistochemical staining using the chromogranin A monoclonal antibody was marginally useful for predicting the outcome in prostate cancer patients after radical prostatectomy, especially in node positive patients. However, it is important to determine a therapeutic plan for patients with low PSA and internal organ metastasis.
