EJMS

Abstract

Neuroendocrine (NE) cells containing neurosecretory granules, rich in various peptide hormones and biogenic amines are components of the human prostatic epithelium. The NE cells probably have a paracrine or local regulatory role in both prostatic growth and differentiation as well as the exocrine secretory process. These cells may be involved in the etiology of benign prostatic hyperplasia (BPH). In prostatic tumor lesions, the population of NE-like cells, i.e., cells exhibiting NE phenotypes and expressing NE markers, is increased and a number of clinical studies suggest that these NE cells might have a role in the development of prostatic carcinoma and its progression. Objective: The aim of this was to study the neuroendocrine differentiation in hyperplastic and conventional prostatic adenocarcinoma and assessment of the relationship of the extent of NE status to the commonly recognized prognostic variables. Also evaluation of the relative significance of immunohistochemically detected expression of two markers, CgA and synaptophysin Methods: This study included fifteen patients with benign prostatic hyperplasia and twenty three cases with prostatic adenocarcinoma. Immunohistochemical analysis using chromogranin A and synaptophysin antibodies, was carried out. Results: Neuroendocrine (NE) markers were seen in a total (55.26%) in chromogranin A and Synaptophysin in only (44.73%). In benign prostatic hyperplasia, CGA and synaptophysin were expressed in (33.3%, 20%respectively) and in prostatic adenocarcinoma (69.6%, 60.90%, respectively). The Chromogranin A and synaptophysin showed the highest correlations with Gleason score (p = 0.015 and p = 0.014, respectively) as well as both markers showed the highest correlations with pathological tumor stage (p = 0.001 and p = 0.002, respectively). Conclusion: The present data suggest that, the growth of hyperplastic prostatic tissue may be related to NE cell activity, and NE differentiation cells may represent a dependent indicator of poor prognosis in patients with prostatic carcinoma.