Korelacija fokalne neuroendokrine diferencijacije u karcinomu prostate sa parametrima od prediktivnog značaja

Milica Lj Mijovic; Aleksandar  Ćorac; Sonja  Smiljić; Sladjana Savić; Predrag  Mandić; Leonida Vitković; Snežana Leštarević; Snežana Janićijević Hudomal

doi:10.2298/VSP170930019M

Milica Lj Mijovic University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Pathology, Kosovska Mitrovica, Serbia
Aleksandar Ćorac University of Priština/Kosovska Mitrovica, Faculty of Medicine, Department of Preventive Medicine, Kosovska Mitrovica, Serbia
Sonja Smiljić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Physiology, Kosovska Mitrovica, Serbia
Sladjana Savić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Histology, Kosovska Mitrovica, Serbia
Predrag Mandić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Anatomy, Kosovska Mitrovica, Serbia
Leonida Vitković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Histology, Kosovska Mitrovica, Serbia
Snežana Leštarević University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Histology, Kosovska Mitrovica, Serbia
Snežana Janićijević Hudomal University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Pharmacology, Kosovska Mitrovica, Serbia

DOI: https://doi.org/10.2298/VSP170930019M

Keywords: prostata, neoplazme, neuroendokrinologija, prostata, specifični antigen, faktori rizika, neoplazme, određivanje stadijuma, prognoza

Abstract

Apstrakt

Uvod/Cilj. Neuroendokrine (NE) ćelije su deo epitelne populacije prostate. Dobro je poznato da fokalna neuroendokrina diferencijacija (FNED) u karcinomu prostate (KP) predstavlja agresivni subtip, koji obično nastaje iz već postojećeg KP koji nije pokazao nikakav odgovor na hormonsku terapiju (tzv. androgen nezavisni KP). Incidenca i klinički značaj FNED u KP nisu u potpunosti razjašnjeni zbog kontradiktornih rezultata studija i zbog toga što se evaluacija FNED ne primenjuje rutinski u kliničkoj praksi. Cilj ove studije bio je utvrđivanje značaja prisusutva FNED u ispitivanim patološkim promenama u prostati sa posebnim osvrtom na odnos stepena FNED u KP sa nekim parametrima od prediktivnog značaja [Gleason score, preoperativne vrednosti ukupnog serumskog prostata specifičnog antigena (PSA), tumorski volumen i klinički stadijum]. Metode. Studija je sprovedena na biopsijskom materijalu 100 uzastopnih patoloških promena prostate: 70 KP, 20 prostatičnih intraepitelnih neoplazija (PIN) i 10 benignih hiperplazija prostate (BHP). Bolesnici sa PIN i BHP činili su kontrolnu grupu. Kalupi sa najreprezentativnijim uzorcima patoloških promena dijagnostikovanih na rutinskim hematoksilin-eozin preparatima, imunohistohemijski su obojeni na tkivni PSA (za obeležavanje prostatičnih sekretornih ćelija) i hromogranin A, serotonin i sinaptofizin (za obeležavanje NE ćelija). Rezultati. Veoma izražen stepen FNED nađen je kod 16 (22,9%) KP. Među njima, kod 10 (62,5%) je dijagnostikovan Gleason score ≥ 7, prosečna vrednost serumskog PSA bila je 32,62 ± 30,80 ng/mL, prosečni tumorski volumen bio je 43,18±31,45 mL, dok su 6 (37,5%) KP otkrivene u D klini-čkom stadijumu sa verifikovanim udaljenim hematogenim metastazama. FNED je bio u negativnoj korelaciji sa vrednostima serumskog PSA, Gleason skorom i kliničkim stadijumom i pozitivno je korelisan sa tumorskim volumenom, ali bez statistički značajne razlike. Zaključak. FNED nema značajnu ulogu u prognozi karcinoma prostate.

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