CLINICAL IMPLICATION OF NEUROENDOCRINE DIFFERENTIATION IN PROSTATIC ADENOCARCINOMAS

Specimens from 75 cases of prostatic adenocarcinoma of different M.D. Anderson degrees of malignancy were stained immunohistochemically for neuron-specific enolase (NSE), prostatic specific antigen (PSA) and pr ostatic acid phosphatase (PAP). None of these tumors presented on hema toxylin-eosin sections any features suggesting neuroendocrine differen tiation; nevertheless, 18.7% of the tumors were at least focally NSE p ositive, Because of the synchronous antigenic expression of the NSE-po sitive cells to PSA and PAP, the authors suggest that prostatic exocri ne and neuroendocrine cells derive from a common precursor stem cell. The possibility of a more aggressive biological behavior of these tumo rs in comparison to the conventional carcinomas is discussed. The prob able clinical necessity for a combined therapeutic approach is also in vestigated.