SERUM CHROMOGRANIN-A - EARLY DETECTION OF HORMONAL RESISTANCE IN PROSTATE-CANCER PATIENTS

We monitored both chromogranin A (CgA) and neuron specific enolase (NS E) in serial serum specimens from 14 patients with prostate cancer (CA P patients) showing resistance to hormonal treatment. Elevated serum C gA was detected in 10 out of these 14 patients (71%) during treatment, and an early appearance of elevated serum CgA was found in 6 of 14 (4 3%) of these patients when serum tPSA levels were still in the normal range. If patients with radical prostatectomy were not included, the p ercentage of patients showing an early appearance of elevated serum Cg A would have been much higher, Elevated serum CgA levels also were fou nd in patients not subject to hormonal therapy. Serial specimens from two out of three pros tate cancer patients, randomly selected, contain ed elevated serum CgA. Serum NSE was not detectable in any of the seri al specimens we studied, suggesting that CgA, not NSE, should be used as a marker for neuroendocrine differentiation. We also compared the s erum CgA in random serum specimens between patients with BPH (benign p rostate hyperplasia) and with prostate cancer in the concentration ran ge of serum tPSA between 3-15 ng/mL, Although serum CgA concentrations in BPH patients overlapped considerably with those levels in patients with prostate cancer, levels > 100 ng/mL should suggest prostate canc er. The early appearance of elevated serum CgA allows an early change of therapy to be made and can lead to the effective prevention of any further development of metastases. (C) 1998 Wiley-Liss, Inc.