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Kim, Choe, Hong, Byun, Lee, and Lee: Pathological Characteristics of Neuroendocrine Cell Differentiation in Prostate Cancer
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(2): 143-151.

Published online: 28 February 2007

DOI: https://doi.org/10.4111/kju.2007.48.2.143

Pathological Characteristics of Neuroendocrine Cell Differentiation in Prostate Cancer

Yong June Kim, Gheeyoung Choe1, Sung Kyu Hong2, Seok-Soo Byun2, Sang Eun Lee2, Nam Kyu Lee3

Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea.

1Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.

2Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.

3Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.

Corresponding author (selee@snubh.org)

Received 28 July 2006       Accepted 5 September 2006

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

Neuroendocrine (NE) cells in a prostate carcinoma may play important roles in tumor growth, proliferation and progression. The aim of this study was to evaluate the relationship between the NE cell differentiation status and pathological characteristics of prostate cancer.

Materials and Methods

Radical prostatectomy specimens from 215 patients were available for analysis. NE cell were detected by immunohistochemistry, using antibodies to chromogranin A (CgA). Tumor cell proliferation was assessed using the Ki-67 proliferation index (PI) employing the MIB-1 antibody. Staining of CgA was scored as: 0= no staining; 1= staining cell <10; 2= staining 10-20; and 3= staining cell >20. Tumors were classified depending on their staining score, positive staining and growth pattern.

Results

NE cell differentiation was present in 25.1% (54/215) of tumors. The amount of NE cells significantly increased; from tumors with solitary scattered NE cells to both small and large clusters (p<0.05). NE cell differentiation and the growth pattern were correlated with the Ki-67 PI (p<0.05). With respect to high-grade tumors, an increased PI was found in tumors with positive NE cells compared with those with negative NE (p<0.05). Pathologically advanced tumors, or those with higher histological grades, were associated with NE cell differentiation and Ki-67 PI (p<0.05).

Conclusions

NE cell differentiation in prostate cancer may lead to increased proliferation, high-grade tumors and an advanced stage. The exact prognostic significance of NE still has to be addressed in larger prospective, comparative and highly selective clinical studies.

Keywords: Prostate, Carcinoma, neuroendocrine, Ki-67 antigen

Figures and Tables

Fig. 1
Immunohistochemical staining with chromogranin a shows neuroendocrine cell differentiation in neoplastic glands. (A) Immunostaining score: +1. (B) Immunostaining score: +2. (C) Immunostaining score: +3 (×100).
kju-48-143-g001
Fig. 2
Immunohistochemical staining with chromogranin A shows neuroendocrine cell differentiation in neoplastic glands. Tumors were categorized by the distribution patterns of neuroendocrine differentiation. (A) Neuroendocrine cells are scattered in the glands (no cluster). (B) Neuroendocrine cells are in small clusters. (C) Neuroendocrine cells are in large clusters (×100).
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Fig. 3
Immunohistochemical staining with MIB-1 shows Ki-67 expression in neoplastic glands. (A) Low Ki-67 proliferation index: ≤6%. (B) High Ki-67 proliferation index: >6% (×400).
kju-48-143-g003
Table 1
Clinical characteristics of patients with prostate cancer after a radical prostatectomy (n=215)
kju-48-143-i001

Data are shown as mean±standard deviation and the number of subjects, with the percentage in parentheses. PSA: prostate-specific antigen

Table 2
Serum PSA, histological grade, pathological stage and tumor volume in prostatic carcinoma (n=215) according to the neuroendocrine cells and Ki-67 proliferation index
kju-48-143-i002

*Student's t-test, †chi-square test. Data are shown as mean±standard deviation and the number of subjects, with the percentage in parentheses. NE: neuroendocrine, PSA: prostate-specific antigen, PI: proliferation index

Table 3
Mean proliferation index, as determined by Ki-67 expression, in the hot spot of neuroendocrine cell differentiation in prostatic carcinomas
kju-48-143-i003

*Student's t-test. Data are shown as mean±standard deviation. PI: proliferation index, NE: neuroendocrine

Table 4
Histological grade and pathological stage in prostatic carcinomas (n=215) stratified in relation to the neuroendocrine cell and Ki-67 proliferation index
kju-48-143-i004

*chi-square test. Data are shown as the number of subjects, with the percentage in parentheses. NE: neuroendocrine, PI: proliferation index

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