PAP(前立腺性酸性ホスファターゼ)高値の前立腺癌の予後 - Stage D0という分類に関する考察 -

Abstract

前立腺癌1029例を対象に初診時PAPが高値の症例をstage D0に分類し, この分類を採用した場合と採用しない場合の生存曲線を比較するとともに, あわせてPAS値と予後の関係を検討した.その結果, stage D0を採用しない場合には予後と良好な相関が認められたが, stage D0分類を採用した場合には予後との関連が明確ではなかった.PSA値の検討では, PSA値が高値な群ほど有意に予後が悪く, stage D1, 2を除いた症例(転移を認めない症例)のみでの検討でも, PSA高値な群ほど有意に予後が悪かった.以上より, PAP値は臨床的stagingに匹敵するような予後因子とはいえず, PSAの測定がルーチンとなった現在における有用性は低いものと思われた

To evaluate the significance of prostatic acid phosphatase (PAP), we analyzed 1, 029 prostate cancer patients who were treated at the Niigata Cancer Center. We classified clinically localized prostate cancer with elevated PAP as stage DO. When stage DO was not taken into acount, the 5-year cause-specific survival rate for stage A, B, C and D was 94.7, 97.9, 87.7 and 42.4%, respectively. Taking stage DO into account, the cause-specific survival curve for stage DO patients was similar to those for stage B, C patients. The 5-year cause-specific survival rate for stage DO was 92.2% considering above 3 ng/ml as elevated PAP. A significant correlation was found between PAP and cause-specific survival for all cases but no correlation was found for non-metastatic disease patients. The significance of PAP in the staging of prostate cancer is limited.