The possible role of chromogranin A as a prognostic factor in organ-confined prostate cancer

Abstract

The clinical significance of neuroendocrine differentiation in patients who have undergone surgery for localized prostate cancer is still unclear. The aims of this study were to assess the relationship between serum neuroendocrine markers and well-known prognostic factors in prostate cancer (pathological staging, definitive Gleason score and serum PSA) and to search for correlations between serum chromogranin A (CgA) levels and pathological findings. Forty-one consecutive patients who had undergone radical retropubic prostatectomy for clinically localized prostate cancer were evaluated. Serum PSA, CgA and neuron-specific enolase were measured immediately before surgery. Twenty-six surgical specimens were phenotypically and immunohistochemically evaluated using an antibody against CgA. Significant correlations were found between serum CgA, pathological staging and Gleason score (p=0.049 and p=0.038, respectively). Serum CgA did not correlate with PSA, patient age, or immunohistochemical findings. There was a significant correlation between positive immunohistochemical CgA staining and Gleason score (p=0.014). An increase in serum CgA levels, independent of PSA values, might be the expression of pathologically more advanced tumor stage and higher Gleason score; this could help to identify a high-risk patient group eligible for adjuvant therapy.

Beyond prostate-specific antigen: alternate serum markers

“…Some report its utility in early diagnosis, particularly when used in conjunction with free/total PSA ratio; 9,10 however, others have found CgA does not accurately distinguish benign from malignant disease. 11 Similar controversy exists between CgA and tumor characteristics, [10][11][12] and CgA does not appear to be prognostic of disease recurrence after radical prostatectomy (RP) or radiation therapy. 13,14 Inconsistencies may be explained by the fact that while most CaPs are characterized by NE differentiation, it is a transient and reversible process and thus NE markers may not always be detectable and a subset may have no NE differentiation.…”

The role of serum neuron-specific enolase in patients with prostate cancer: a systematic review of the recent literature

“…Similarly, Kamiya et al found that the mean NSE serum level in metastatic PCa patients was significantly higher than that in nonmetastatic patients (p<0.05) (21). Conversely, 3 other studies did not find any association between the pretreatment serum levels of NSE and T category (17,18,22).…”

“…No additional studies were found in screening the references of those selected articles. Finally, 19 articles including 1,772 patients with confirmed or suspicious PCa were selected for the systematic review (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) (Fig. 1).…”

“…A total of 6 studies in our review investigated the correlation between serum NSE levels and the clinical and/or pathological stage of disease (17)(18)(19)(21)(22)(23). Three of them showed an association between the pretreatment levels of NSE and T category (19,21,23).…”

Combination of insulin-like growth factor-1, IGF binding protein-3, chromogranin A and prostate specific antigen can improve the detection of prostate cancer

“…[25] Some indicate CgA utility in early diagnosis, particularly when used in combination with free/total PSA ratio, [26] however, some studies found that CgA does not precisely differentiate malignant disease. [27] Similar debate occurs regarding CgA and tumor features [28] and CgA does not show any advantage in the prognosis of PCa recurrence after radical prostatectomy or radiotherapy. [29] Inconsistencies may be attributed to the transient and reversible process of neuroendocrine differentiation (NED) in most malignant prostate tumors; thus, these NE molecules are not constantly detectable.…”