Relevance of the neuroendocrine differentiation in prostatic carcinoma

Background. NE tumor cells are present in virtually all prostatic adenocarcinomas. As they express no androgen receptor they are hormone independant. During anti-androgenic therapy their number increases. Their prognostic value is controversial. Material and Methods: In 233 patients with prostatic carcinoma the NE differentiation was determined in a hot spot (7.9 mm(2)) with maximum CgA positive cell density. A high NE differentiation (HNE) was defined by a least 30 NE tumor cells, while less means a low NE differentiation (LNE). In addition the occurrence of NE tumor cells was defined as solitary or clustered (>= 5 NE tumor cells in close proximity). Results: In advanced and high grade tumors more and clustered NE tumor cells could be found than in low grade and organ confined tumors. Moreover HNE tumors and occurrence of NE clusters resulted in a significant shorter progression-free interval. Conclusions: Besides the quantity of NE differentiation the quality of the growth pattern of NE tumor cells is of relevance in prostatic carcinoma.