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Chromogranin A Level May Help Predict Prostate Cancer Prognosis

NEW YORK Feb 26, 2002 (Reuters Health) - In men with prostate cancer, elevated chromogranin A levels are associated with high grade disease, according to a report published in the February issue of The Journal of Urology. When combined with PSA measurements, these levels could be helpful in predicting prognosis after endocrine therapy.

Dr. Shinzou Isshiki and colleagues, from Chiba University in Japan, assessed the predictive value of serum chromogranin A levels in 108 prostate cancer patients and in 66 men with benign prostatic hyperplasia. After chromogranin A determination, the cancer patients received endocrine therapy.

The average chromogranin A concentration in both groups of men was similar, the authors note. Among men with cancer, however, those with poorly-differentiated disease had significantly higher levels (45.3 ng/mL) than those with well-differentiated disease (72.5 ng/mL, p = 0.044).

In patients with stage D disease, survival was significantly lower in patients with chromogranin A levels above the median level of 49.7 ng/mL than in those with lower levels. However, when PSA levels exceeded 172.1 ng/mL, the chromogranin A level had no bearing on prognosis.

The current findings indicate that "cases of prostate cancer associated with low serum PSA and high serum chromogranin A...may show resistance to endocrine therapy and a poor prognosis," the author state.

SOURCE:
The Journal of Urology 2002;167:512-515.


Abstract from PubMed follows:

Chromogranin a concentration as a serum marker to predict prognosis after endocrine therapy for prostate cancer.

Isshiki S, Akakura K, Komiya A, Suzuki H, Kamiya N, Ito H.
Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.

PURPOSE: Chromogranin A is gaining acceptance as a serum marker of neuroendocrine tumors and the concentration is thought to be elevated in relation to neuroendocrine differentiation of prostate cancer. We examined the significance of the chromogranin A level as a serum marker for prostate cancer.

MATERIALS AND METHODS: Serum chromogranin A values were determined by monoclonal immunoradiometric assay in 108 patients with prostate cancer before treatment and in 66 with benign prostatic hyperplasia. In those with prostate cancer clinicopathological parameters, the response to endocrine therapy and the prognosis were evaluated in relation to serum chromogranin A.

RESULTS: Mean serum chromogranin A plus or minus standard deviation in prostate cancer and benign prostatic hyperplasia cases was 59.4 +/- 52.5 and 59.3 +/- 44.3 ng./ml., respectively (not significant). Poorly differentiated adenocarcinoma was associated with higher chromogranin A than well differentiated disease (p = 0.044). Of the stage D cases with a median prostate specific antigen (PSA) of 172.1 ng./ml. or less those with higher chromogranin A had a poorer prognosis than those with lower chromogranin A. In contrast, in stage D cases with a PSA of greater than 172.1 ng./ml. there was no difference in the prognosis between the higher and lower chromogranin A groups.

CONCLUSIONS: Serum chromogranin A tends to be elevated in patients with high grade prostate cancer. When combined with PSA, this marker may effectively predict a poor prognosis after endocrine therapy.


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