Premium
Characterization of neuroendocrine differentiation in human benign prostate and prostatic adenocarcinoma
Author(s) -
Aprikian Armen G.,
CardonCardo Carlos,
Fair William R.,
Reuter Victor E.
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930615)71:12<3952::aid-cncr2820711226>3.0.co;2-x
Subject(s) - chromogranin a , prostate , pathology , immunohistochemistry , adenocarcinoma , neuroendocrine differentiation , medicine , enolase , paraganglioma , prostatic acid phosphatase , androgen , prostate cancer , hormone , cancer
Background. This report describes an immunohistopathologic analysis characterizing the incidence, pattern of distribution, and hormonal content of neuroendocrine (NE) cells in human benign prostate and prostatic adenocarcinoma. Methods . Formaldehyde‐fixed, paraffin‐embedded material from 15 benign prostates, 31 primary prostatic adenocarcinomas, 16 metastatic lesions, 21 primary tumors treated with short‐course diethylstilbestrol (DES), and 10 specimens from hormone‐refractory patients were examined. NE cells were identified using silver histochemistry and a panel of immunohistochemical NE markers (chromogranin‐A, serotonin, neuron‐specific enolase), and specific peptide hormone antibodies. Results . NE cells were identified in all benign prostates. NE cells were identified in 77% of primary untreated adenocarcinomas with no significant differences with respect to pathologic stage. NE cells were found isolated and dispersed in the tumor, composing the minority of malignant cells. Double‐labeling and serial section immunohistochemistry demonstrated the coexpression of prostate‐specific antigen (PSA) in NE cells. In addition to serotonin, some tumors expressed multiple hormone immunoreactivities. NE cells were identified in 56% of metastatic deposits, with a similar pattern of distribution. In DES‐treated cases, NE cells were found consistently in the adjacent benign epithelium, whereas 52% of tumors contained NE cells. Hormone‐refractory tumors contained NE cells in 60% of cases. Conclusions . This analysis demonstrates that a significant proportion of primary and metastatic prostatic adenocarcinomas contain a subpopulation of NE cells, the expression of which does not appear to be suppressed with androgen ablation and does not correlate with pathologic stage. Furthermore, NE cells coexpress PSA, suggesting a common precursor cell of origin. The elaboration of biogenic amines and neuropeptides suggests that NE cells dispersed in prostatic carcinoma may play a paracrine growth‐regulatory role.