Prognostic significance of neuroendocrine differentiation in colorectal adenocarcinoma

Abstract

Objective To investigate the significance of neuroendocrine differentiation in the colorectal adenocarcinoma.Methods Eighty-two cases of colorectal adenocarcinoma operated in the Sun Yatsen Memorial Hospital of Sun Yat-sen University in 2008 were analyzed retrospectively.Immunohistochemistry was used to detect the specific neuroendocrine markers,including chromogranin A (CgA) and synaptophysin (Syn).Results Fifteen out of 82 cases (18.3％) were positive for at least one marker.In 15 cases of colorectal adenocarcinoma,there were 6 cases of neuroendocrine differentiation for stage Ⅱ,6 cases for stage Ⅲ,and 3 cases for stage Ⅳ ; 6 cases of high differentiation,6 cases of moderate differentiation,and 3 cases of poor differentiation ; the rectum was involved in 4 cases,sigmoid colon in 4 cases,descending colon in 1 case,transverse colon in 1 case,and ascending colon in 5 cases.The recurrence and/or metastasis rate in the neuroendocrine differentiation group was significantly higher than in non-neuroendocrine differentiation group (66.7％ vs.29.8％,P ＜ 0.01).The five-year survival rate in neuroendocrine differentiation group was significantly lower than in non-neuroendocrine differentiation group (26.7％vs.52.2％,P ＜ 0.05).Conclusion The expression of specific neuroendocrine markers in the colorectal adenocarcinoma would lead to a poor prognosis of this disease.To promote routine detection of these two specific neuroendocrine makers by immunohistochemistry in the colorectal adenocaicinoma would enhance the judgment of prognosis. Key words: Colorectal adenocarcinoma; Neuroendocrine ; Differentiation ; Prognosis