Changes in immunophenotypes after neoadjuvant endocrine therapy for prostate cancer and their clinical significance

To investigate changes in the immunophenotypes of androgen receptor (AR), prostate-specific antigen (PSA), synaptophysin (Syn), chromogranin A (CgA), p53 and Ki-67 after neoadjuvant endocrine therapy (NET) for prostate cancer (PCa) and to analyze their clinical significance.

Paired paraffin samples were collected from 40 PCa patients before and after NET, and immunohistochemistry were used to detect AR, PSA, Syn, CgA, p53 and Ki-67 expression. Based on The Cancer Genome Atlas (TCGA), Kaplan‒Meier survival curves were plotted for analysis of PSA and Ki-67 expression in relation to progression-free survival (PFS).

After NET, the mean scores for PSA and Ki-67 expression in PCa patients were lower than those before NET (P < 0.05), while the mean scores for Syn and CgA expression were higher than those before NET (P < 0.05). The mean Gleason score and WHO/ISUP (World Health Organization/International Society of Urological Pathology) grade after NET were lower than those before NET (P < 0.05). In PCa patients who had not yet received NET, PSA expression correlated positively with Gleason score and WHO/ISUP grade and negatively with Ki-67 expression (P < 0.05); p53 expression correlated negatively with Gleason score and WHO/ISUP grade (P < 0.05). TCGA showed that PFS was lower in PCa patients with high PSA and Ki-67 expression (P < 0.05).

PSA and Ki-67 protein expressions decreased significantly in PCa patients after NET and can be used as biological markers for prognostic assessment of PCa patients. NETs may induce a neuroendocrine (NE) phenotype in PCa. Monitoring the immunophenotypes of PCa patients after NET may inform assessment of efficacy and prognosis.