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Neuroendocrine differentiation in colorectal carcinomas
U Syversen1, T Halvorsen, R Mårvik
1Institute of Cancer Research, University of Trondheim, Norway.
European Journal of Gastroenterology & Hepatology
|July 1, 1995
Summary
Neuroendocrine differentiation is present in 40% of colorectal carcinomas, particularly those of midgut origin. Elevated serum chromogranin A (CgA) and pancreastatin-like immunoreactivity (PST-LI) suggest prognostic value for these markers in colorectal cancer.
Area of Science:
- Gastroenterology and Oncology
- Biomarker Discovery
- Tumor Biology
Background:
- Colorectal carcinomas can exhibit neuroendocrine differentiation (NED).
- Chromogranin A (CgA) and neuron-specific enolase (NSE) are markers of NED.
- Serum levels of CgA and pancreastatin-like immunoreactivity (PST-LI) may reflect tumor status.
Purpose of the Study:
- To evaluate NED in colorectal tumors using CgA and NSE immunostaining.
- To correlate tumor NED with serum CgA and PST-LI levels.
- To investigate NED in colorectal carcinomas based on embryonic origin (midgut vs. hindgut).
Main Methods:
- Immunohistochemistry for CgA and NSE on 91 colorectal carcinoma tumor samples.
- Radioimmunoassays for serum CgA and PST-LI in 55 patients.
- Correlation analysis between tumor markers, serum markers, and patient outcomes.
Main Results:
- NED markers (CgA/NSE) were found in 40% of colorectal carcinomas.
- NSE expression was higher in midgut-derived than hindgut-derived tumors.
- Elevated serum CgA and PST-LI were observed in 38% and 43% of patients, respectively.
- Serum CgA levels were significantly higher in midgut vs. hindgut tumors.
- Higher serum CgA and PST-LI levels correlated with mortality in hindgut tumors.
Conclusions:
- NED is a common feature in colorectal carcinomas, more prevalent in midgut-derived tumors.
- Serum CgA and PST-LI are elevated in colorectal cancer patients.
- NED and elevated serum markers may indicate a poorer prognosis in colorectal cancer.