Correlation between neovascularisation and neuroendocrine differentiation in prostatic carcinoma

Neuroendocrine (NE) differentiated tumor cells are found in almost all pros tatic carcinomas. Prostatic carcinomas with a high NE differentiation have a poor prognosis and increased metastatic potential. A relationship between the neovascularisation density in the tumor and the metastatic potential i n prostatic carcinoma is well known. NE cells and microvessels were demonst rated immunohistochemically on 102 radical prostatectomy specimens using an tibodies against Chromogranin A and CD34. Standard areas (7.9 mm(2)) of max imal Chromogranin A expression and highest vascularisation were determined and topographically related by light microscopy. Area density of microvesse ls was evaluated morphometrically. NE tumor cells were present in all prost atic carcinomas studied. High grade prostatic carcinomas expressed signific antly more NE tumor cells and exhibited a higher neovascularisation than lo w grade carcinomas. There was significantly higher neovascularisation in hi gh grade tumors with many, as compared to high grade tumors with few, NE tu mor cells. Poorer pathological staging correlated with increased neovascula risation and stronger NE differentiation. A topographical relationship betw een the area of maximal NE tumor cells and the area of highest neovasculari sation was found in 80.4% of all cases. An analysis of variance revealed a large number of NE tumor cells as the only predictor of an increased neovas cularisation (p = 0.0006). These observations support the concept that incr eased neovascularisation is influenced not only by poor pathological gradin g but also by a high NE differentiation.