The Possible Role of Chromogranin A as a Prognostic Factor in Organ-Confined Prostate Cancer

Grimaldi, Franco; Valotto, Claudio; Barbina, Giuseppe; Visentini, Daniela; Trianni, Annalisa; Cerruto, M.A.; Zattoni, Filiberto

doi:10.1177/172460080602100406

Cited by 11 publications

(4 citation statements)

References 28 publications

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“…Neuroendocrine differentiation also appeared to be associated with the androgen-refractory state and a poor prognosis [6,23-26]. It was reported that prostate cancer with a significant NE component is common in the advanced stage of the disease, especially in those patients who do not have elevated serum PSA levels [7,25,27,28], but its diagnostic role in non metastatic disease is still a matter of debate [8,29,30]. We analyzed serum CgA levels in patients who were diagnosed with a prostate cancer before surgery.…”

Section: Discussionmentioning

confidence: 99%

Incidence of high chromogranin A serum levels in patients with non metastatic prostate adenocarcinoma

Appetecchia¹,

Meçule²,

Pasimeni³

et al. 2010

J Exp Clin Cancer Res

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BackgroundChromograninA in prostate carcinoma (PC) indicate NE differentiation. This tumour is more aggressive and resistant to hormone therapy.Patients and methodsWe analyzed the incidence of pre-operative ChromograninA serum levels in non metastatic PC patients. Serum PSA and ChromograninA were analyzed before treatment. Clinicopathological parameters were evaluated in relation to serum ChromograninA. 486 patients were enrolled.ResultsWe found 352 pT2 and 134 pT3. 21 patients were N+. 278 patients had Gleason score levels <7; 173 patients had levels = 7 (122 were 3+4 and 51 4+3); and 35 patients with levels >7. Median PSA pre-operative level was 7.61 ng/ml. PSA was significantly associated with pT stage (pT2 with PSA abnormal 23.6% vs pT3 48.5%, p < 0.0001) and with a Gleason score (PSA abnormal 60% in the Gleason score was >7 vs 29.5% in the Gleason score = 7 vs 27.3% in the Gleason score <7, p < 0.0001). In 114 patients pre-operative ChromograninA levels were elevated (23.5%). Serum ChromograninA levels had no significant association with PSA (p = 0.44) and pT stage (p = 0.89). abnormal ChromograninA levels increased from a Gleason score of <7 (25.5%) to >7 (31.4%) (p = 0.12). The serum ChromograninA levels in the two groups of patients were subdivided before and after 2005 on the basis of different used assays, showing no correlation with serum ChromograninA and other parameters.ConclusionsThis study showed that ChromograninA levels correlated to NE differentiation and possible aggressiveness of PC. Pre-operative circulating ChromograninA could complement PSA in selecting more aggressive PC cases, particularly in the presence of a higher Gleason score. Complementary information is provided by the absence of a correlation between serum ChromograninA and PSA levels.

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Section: Discussionmentioning

confidence: 99%

Incidence of high chromogranin A serum levels in patients with non metastatic prostate adenocarcinoma

Appetecchia¹,

Meçule²,

Pasimeni³

et al. 2010

J Exp Clin Cancer Res

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“…Thirty‐three of these studies correlated the presence of neuroendocrine staining to patient outcomes such as biochemical recurrence, clinical progression, overall survival and prostate cancer‐specific survival. The characteristics of the included studies are summarized in Table 1 [19–80] and Table S2.…”

Section: Resultsmentioning

confidence: 99%

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

et al. 2021

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To perform a systematic review and meta-analysis of the literature to understand the variation in the reporting of neuroendocrine staining and determine the influence of reporting neuroendocrine staining at diagnosis on patient outcomes. MethodsMedical databases were searched to identify studies in which adenocarcinoma specimens were stained with any of the following four neuroendocrine markers: chromogranin A (CgA), neuron-specific enolase (NSE), synaptophysin and CD56. The prevalence of neuroendocrine staining and correlation of the prevalence of neuroendocrine staining to patient outcomes were analysed using a random-effects model. All statistical tests were two-sided. ResultsSixty-two studies spanning 7616 patients were analysed. The pooled prevalence for the most common marker, CgA (41%), was similar to that of NSE (39%) and higher than that of synaptophysin (31%). The prevalence of CgA staining was significantly influenced by reporting criteria, where objective thresholds reduced the variation in prevalence to 26%. No correlation was found between CgA prevalence and tumour grade. Patients positive for CgA staining using objective criteria had more rapid biochemical progression (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.49 to 2.65) and poorer prostate cancer-specific survival (HR 7.03, 95% CI 2.55 to 19.39) compared to negative patients, even among those with low-risk cancers. ConclusionDiscrepancies in the reported prevalence of neuroendocrine cells in adenocarcinoma are driven by the inconsistent scoring criteria. This study unequivocally demonstrates that when neuroendocrine cell staining is assessed with objective criteria it identifies patients with poor clinical outcomes. Future studies are needed to determine the exact quantifiable thresholds for use in reporting neuroendocrine cell staining to identify patients at higher risk of progression.

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“…Numerous studies also assessed the prognostic value of serum CgA expression in prostate patients, with controversial results [22][23][24][25]. Elevated serum CgA was reported to be an independent prognostic factor for OS and progression-free survival in CRPC patients treated with abiraterone acetate [26] and was related to advanced tumor stage and higher GS [27]. An elevated serum CgA level over three times the upper normal limit in mCRPC patients was a prognostic factor in patients treated with enzalutamide [28].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Chromogranin A Expression in the Initial and Second Biopsies in Metastatic Prostate Cancer

Huang

Tang

Wei

et al. 2023

JCM

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Neuroendocrine differentiation (NED) characterized by the expression of neuroendocrine markers, such as chromogranin A (CgA), is frequently observed in advanced prostate cancer (PCa), the prognostic significance of which is still controversial. Here we specifically addressed the issue of the potential prognostic value of CgA expression in advanced-stage PCa patients with distant metastases and its change over time from metastatic hormone-sensitive (mHSPC) to metastatic castration-resistant prostate cancer (mCRPC). CgA expression was assessed immunohistochemically in initial biopsies of mHSPC, as well as in second biopsies of mCRPC in sixty-eight patients, and its correlation with prognosis (together with conventional clinicopathologic parameters) was analyzed using the Kaplan–Meier method and Cox proportional hazard model. We found that CgA expression was an independent adverse prognostic factor for both mHSPC (CgA positivity ≥ 1%, HR = 2.16, 95% CI: 1.04–4.26, p = 0.031) and mCRPC (CgA ≥ 10%, HR = 20.19, 95% CI: 3.04–329.9, p = 0.008). CgA positivity generally increased from mHSPC to mCRPC and was a negative prognosticator. The assessment of CgA expression may help with the clinical evaluation of advanced-stage patients with distant metastases.

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The Possible Role of Chromogranin A as a Prognostic Factor in Organ-Confined Prostate Cancer

Cited by 11 publications

References 28 publications

Incidence of high chromogranin A serum levels in patients with non metastatic prostate adenocarcinoma

Incidence of high chromogranin A serum levels in patients with non metastatic prostate adenocarcinoma

Neuroendocrine cells in prostate cancer correlate with poor outcomes: a systematic review and meta‐analysis

Prognostic Significance of Chromogranin A Expression in the Initial and Second Biopsies in Metastatic Prostate Cancer

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