ArticleBMC urology2026
Prognostic significance of neuroendocrine differentiation and PD-L1 expression in treatment-naïve prostate cancer.
Article in BMC urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeProstatic adenocarcinoma with neuroendocrine differentiation (PaNED) is distinct from treatment-related and de-novo neuroendocrine prostate carcinomas, yet remains under-investigated in treatment-naïve patients. This study aimed to evaluate the associations of NED extent, synaptophysin intensity score (SIS), and PD-L1 expression with other histomorphological features and prognosis in treatment-naïve PaNED. MATERIALS AND
methodsSeventeen patients with PaNED diagnosed between 2014 and 2024 were retrospectively analyzed. NED was classified as diffuse (≥ 30%) or focal (< 30%), and SIS was scored as weak (+ 1), moderate (+ 2), or strong (+ 3). PD-L1 expression was assessed using tumor proportion score (TPS, cut-off ≥ 1%) and combined positive score (CPS, cut-off ≥ 10). Clinicopathological data and survival outcomes were evaluated.
resultsThe mean age was 65.2 ± 6.6 years, and 47.1% (n = 8) of the cases were Grade Group 5. Diffuse NED was observed in 70.6% of cases, and strong synaptophysin expression in 35.3%. PD-L1 TPS and CPS positivity were detected in 17.6% and 35.3% of patients, respectively. Neither NED extent nor percentage was significantly associated with PD-L1 expression or prognosis. A moderate negative correlation was found between SIS and PD-L1 CPS (rho = -0.48, p = 0.051). Strong synaptophysin expression was significantly associated with shorter overall survival (p = 0.031).
conclusionsIn treatment-naïve PaNED, higher SIS was correlated with lower PD-L1 CPS values, and strong synaptophysin expression was associated with poorer survival. Assessment of SIS in morphologically suspected neuroendocrine areas may provide additional prognostic information and help predict the PD-L1 response. Larger studies are required to validate these findings.
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