USE OF NEUROENDOCRINE SERUM MARKERS IN THE FOLLOW-UP OF PATIENTS WITHCANCER OF THE PROSTATE

Neuroendocrine (NE) differentiation of prostatic adenocarcinomas has r eceived increasing attention in recent years as a result of possible i mplications on prognosis and therapy. The incidence of NE cells in tum ors has been reported from 10% up to 100%. Several studies have shown chromogranin A (CgA) to be the most reliable serum marker of NE differ entiation. We have followed 22 patients with prostatic adenocarcinoma over a 2-year period. The patients underwent a palliative transurethra l resection of the prostate (TURF) because of urinary outflow obstruct ion. The prostatic tissue specimens were stained immunohistochemically using antibodies against CgA, chromogranin B (CgB), neuron-specific e nolase (NSE), thyroid-stimulating hormone (TSH), serotonin, and somato statin. In addition, each specimen was stained with hematoxylin & eosi n (H & E), and saffran for tumor grading. Blood samples were taken pre operatively and after 1, 3, 6, and 24 months. The serum values of CgA, CgB, pancreastatin (Pst), NSE, and prostate-specific antigen (PSA) we re determined from each sample. Carcinomas with groups of CgA-positive cells had higher serum levels of CgA compared to carcinomas with no o r only scattered CgA-positive NE cells. During the 2-year period, ther e were no statistical significant variations in serum levels of CgA, N SE, Pst, and PSA. However, there was a significant increase in serum l evels of CgB during the same period, P = 0.002, possibly due to an inc rease in number of NE cells in tumor or to a relative increase in prod uction of CgB in the NE cells. (C) 1997 Wiley-Liss, Inc.