PMID: 16625864Apr 22, 2006Paper

The neuroendocrine phenotype in prostate cancer: basic and clinical aspects

Journal of Endocrinological Investigation
A MoscaL Dogliotti

Abstract

Most of the conventional adenocarcinomas of the prostate display focal neuroendocrine (NE) differentiation at diagnosis, usually revealed by immunohistochemistry as solitary or clusters of cells, in the context of predominantly exocrine tumors. Even though the biological and clinical significance of NE differentiation in prostate cancer is still to be elucidated, NE phenotype is emerging as an important factor in the prognosis, evolution and progression of prostate cancer. It seems to be particularly relevant in facilitating prostate cancer progression during the ordinary androgen-suppression therapy (LHRH-analogs +/- anti-androgens). Several mechanisms have been identified: NE cells are androgen receptor negative, therefore they survive to androgen deprivation; NE cells produce peptides, hormones and growth factors which could stimulate proliferation [chromogranin (A-CgA), PTHrp, bombesin, etc.], inhibit apoptosis (Survivin) and stimulate neoangiogenesis [vascular endothelial GF (VEGF)] of the neighbouring exocrine prostate cancer cells. NE differentiation appears to be a dynamic phenomenon. The NE phenotype expression increases during androgen-deprivation therapy and results more elevated in hormone refractory than in hormone...Continue Reading

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