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Assessment of Serum Chromogranin-A as Prognostic Factor in High-Risk Prostate Cancer
  1. Leonardo O. Reis, MD, MSc*,
  2. Larissa F.M. Vieira,
  3. Emerson L. Zani, MD,
  4. Fernandes Denardi, MD, PhD*,
  5. Laurione C. de Oliveira,
  6. Ubirajara Ferreira, MD, PhD*
  1. From the *Urologic Oncology, Department of Surgery, Faculty of Medical Sciences, and †Laboratory of Physiology, University of Campinas (UNICAMP), Campinas, Brazil.
  1. Received July 13, 2010, and in revised form July 29, 2010.
  2. Accepted for publication August 5, 2010.
  3. Reprints: Leonardo Oliveira Reis, MD, MSc, R. Votorantim 51, ap. 43, Campinas, SP, Brazil, 13073-090. E-mail: reisleo{at}unicamp.br.
  4. Supported by the Foundation to Support Education, Research and Extension (FAEPEX), an organ of the University of Campinas (UNICAMP). This project was also awarded a scholarship for scientific initiation at the Institutional Program for Scientific Initiation (PIBIC).

Abstract

Purpose The presence of neuroendocrine differentiation may play a key role in androgen-independent tumor progression. The prognostic significance of plasma chromogranin-A (CgA) was assessed in a series of consecutive patients with high-risk prostate cancer (PCa).

Patients and Methods Twenty-three patients presenting high-risk PCa and 8 healthy individuals, as control group, had their blood samples collected to evaluate CgA, free and total prostate specific antigen, and free and total testosterone in a pilot study. The correlations of serum CgA levels with PSA, testosterone, Gleason score, number of foci of hypercaptation in bone scan, age, and outcomes were evaluated at baseline and after 12 months.

Results Patients with PCa had significantly higher levels of plasma CgA (mean, 8.7; range, 1.9-73) than healthy patients (mean, 3.45; range, 0.6-5.6), P = 0.02. Analyzing only the patients group through correlation of the ranks, it was observed that CgA has low, insignificant correlations with PSA (P = 0.07) and with metastatic extension (P = 0.09). No association was found between the plasma CgA levels and the Gleason score (P = 0.20), age (P = 0.15), or disease progression (P = 0.27).

Conclusion The serum levels of CgA were significantly increased in the group with PCa compared with the healthy group. However, there were low correlations between serum CgA and known prognostic factors (such as total and free PSA, age, Gleason score, and bone metastases) or clinical deterioration. Although future studies are needed with larger samples and longer follow-up, the presented data envisage a limited role to serum CgA as high-risk PCa prognostic factor.

Key Words
  • serum
  • chromogranin-A
  • prognostic factor
  • high risk
  • prostate cancer
  • PSA
  • Gleason
  • neuroendocrine
  • metastasis
  • testosterone
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