Neuroendocrine markers; chromogranin, pancreastatin and serotonin in the management of patients with advanced renal cell carcinoma.

A fraction of patients with renal cell carcinoma (RCC) exhibit elevated plasma levels of neuroendocrine (NE) markers, including chromogranin (Cg) A and B, pancreastatin and serotonin. This may suggest neuroendocrine involvement in human RCC. Twenty eight patients (24 men and 4 women) with advanced RCC were included in this study. The ongoing therapy was either tamoxifen, or interleukin-2 (IL-2); alpha interferon and tamoxifen. Plasma analyses of NE markers revealed elevated levels of CgA and serotonin in 28/28 (100%) patients. CgB was elevated in 5/16 (31%) patients, whereas no elevation of pancreastatin was observed in these 16/28 patients. Although the plasma levels of NE markers did not statistically or significantly influence the prognosis of the disease it was observed that patients with elevated NE markers had a less aggressive disease and lived longer than patients with normal or only slightly elevated NE markers. Immunohistochemical analyses of tumour specimens from 10 patients were chromogranin, serotonin and synaptophysin negative, but all were neurone-specific enolase (NSE) positive. The results obtained are of interest. However, extended studies are needed to define the role of these NE markers in the clinical management of patients with RCC.