NEUROENDOCRINE DIFFERENTIATION IN PROSTATIC ADENOCARCINOMA AND LAS RELATIONSHIP TO TUMOR PROGRESSION

Background. Neuroendocrine differentiation has been demonstrated by im munohistochemical preparations in many cases of acinar type prostatic adenocarcinoma (CAP). Some studies have suggested that this differenti ation may indicate an adverse prognosis. Methods. Tissue samples from 38 consecutive patients with clinical Stage IL (AJCC) CAP who underwen t radical retropubic prostatectomy (RRP) were studied after preparatio ns were made with antichromogranin (ChA) and neuron-specific enolase ( NSE). All patients were followed for at least 4 years post-RRP or unti l disease progression was documented by rising serum prostate specific antigen concentration, X-ray evidence of recurrence, or a positive ti ssue biopsy. Results. Nine of the 38 RRP specimens (24%) were positive for NSE, and 11 (29%) were positive for ChA. Neither of these neuroen docrine markers showed a significant correlation with tumor progressio n. Neuroendocrine differentiation in needle biopsy specimens from thes e same patients (when available) did not correlate with tumor progress ion either. Of the patients with tumor progression, 9 of 11 (82%) had pathologic Stage III disease after RRP; of those with no progression o f CAP, only 7 of 27 (26%) had pathologic Stage III disease. Conclusion s. Neuroendocrine differentiation, as demonstrated by NSE and ChA prep arations, was not helpful in predicting tumor progression of CAP.