Korean J Urol.  2007 Feb;48(2):143-151. 10.4111/kju.2007.48.2.143.

Pathological Characteristics of Neuroendocrine Cell Differentiation in Prostate Cancer

  • 1Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea.
  • 2Departments of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Departments of Urology, Seoul National University Bundang Hospital, Seongnam, Korea. selee@snubh.org
  • 4Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea.


PURPOSE: Neuroendocrine (NE) cells in a prostate carcinoma may play important roles in tumor growth, proliferation and progression. The aim of this study was to evaluate the relationship between the NE cell differentiation status and pathological characteristics of prostate cancer.
Radical prostatectomy specimens from 215 patients were available for analysis. NE cell were detected by immunohistochemistry, using antibodies to chromogranin A (CgA). Tumor cell proliferation was assessed using the Ki-67 proliferation index (PI) employing the MIB-1 antibody. Staining of CgA was scored as: 0= no staining; 1= staining cell < 10; 2= staining 10-20; and 3= staining cell >20. Tumors were classified depending on their staining score, positive staining and growth pattern.
NE cell differentiation was present in 25.1% (54/215) of tumors. The amount of NE cells significantly increased; from tumors with solitary scattered NE cells to both small and large clusters (p<0.05). NE cell differentiation and the growth pattern were correlated with the Ki-67 PI (p<0.05). With respect to high-grade tumors, an increased PI was found in tumors with positive NE cells compared with those with negative NE (p<0.05). Pathologically advanced tumors, or those with higher histological grades, were associated with NE cell differentiation and Ki-67 PI (p<0.05). CONCLISIONS: NE cell differentiation in prostate cancer may lead to increased proliferation, high-grade tumors and an advanced stage. The exact prognostic significance of NE still has to be addressed in larger prospective, comparative and highly selective clinical studies.


Prostate; Carcinoma; neuroendocrine; Ki-67 antigen

MeSH Terms

Cell Differentiation
Cell Proliferation
Chromogranin A
Neuroendocrine Cells*
Prostatic Neoplasms*
Chromogranin A


  • Fig. 1 Immunohistochemical staining with chromogranin a shows neuroendocrine cell differentiation in neoplastic glands. (A) Immunostaining score: +1. (B) Immunostaining score: +2. (C) Immunostaining score: +3 (×100).

  • Fig. 2 Immunohistochemical staining with chromogranin A shows neuroendocrine cell differentiation in neoplastic glands. Tumors were categorized by the distribution patterns of neuroendocrine differentiation. (A) Neuroendocrine cells are scattered in the glands (no cluster). (B) Neuroendocrine cells are in small clusters. (C) Neuroendocrine cells are in large clusters (×100).

  • Fig. 3 Immunohistochemical staining with MIB-1 shows Ki-67 expression in neoplastic glands. (A) Low Ki-67 proliferation index: ≤6%. (B) High Ki-67 proliferation index: >6% (×400).

Cited by  1 articles

Significance of Neuroendocrine Cell Differentiation in Specimens from Patients with Prostate Cancer
Chang Hoo Park, Chang Myeon Park, Han Kwon Kim, Kil Hyeon Gang, Jae Seok Song, Jong Yeon Park
Korean J Urol. 2008;49(7):585-591.    doi: 10.4111/kju.2008.49.7.585.


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