Karol Kajo, Vladimír Bartoš, Lukáš Plank
Objective: Neuroendocrine (NE) differentiation in prostate cancer (CaP) is one of important parameters in the biopsy examination of tumor tissue. Although this phenomenon is present at least focally virtually in all cases of CaP, tumors may show divergent differentiation towards a NE phenotype. Material and methods: A literature review of current status of neuroendocrine differentiation and its importance in the prostate carcinoma. Results: Generally, NE differentiation of CaP occurs in three different forms: as a. small cell carcinoma, b. carcinoid or carcinoid- like tumors, and c. focal NE differentiation in conventional acinar adenocarcinoma. Especially, this last type is very frequent, if not ubiquitous phenomenon, and reflects tumor cell heterogeneity mimicking the normal differentiation process. The prognostic significance of focal NE differentiation remains controversial but current evidence suggests an influence on prognosis related to hormone-resistant tumors and a role in the conversion to a hormone-resistant clinical manifestation. All CaPs originate as an androgen-dependent hyperproliferation of the epithelial cells of the gland and they evolve in an androgen- independent, highly aggressive cancer for which no successful therapy is available to date. Conclusion: Therefore, based on these facts, there is increase need of continual clinico-pathological studies and trials for development of adequate treatment strategies, targeting NE differentiation that may hold the solution for patients with advanced hormone refractory prostate cancer.