腎細胞癌患者における血清可溶性インターロイキン2受容体値 : 手術前後の変化についての検討

Abstract

1)腎細胞癌患者において手術前のsIL-2R値は組織学的gradeや腫瘍容積との相関を示したことから, 腫瘍の悪性度や進行度をある程度反映するものと考えられた.2)術後3ヵ月の時点ではsIL-2Rは術前より有意に上昇しており, 腫瘍マーカーとして有用かどうかは転移出現前後での推移について明らかにする必要がある

This study was carried out in order to find out whether soluble interleukin II receptor (sIL-2R) levels were useful as a treatment biomarker in patients with renal cell carcinoma (RCC). The subjects consisted of 17 patients with RCC who had been scheduled for radical or partial nephrectomy. Serum levels of sIL-2R were measured before surgery and 1 and 3 months after surgery. We also analyzed the relationship of preoperative sIL-2R to pathologic TNM-stage, grading and presumptive tumor volume. The mean value of pre-operative sIL-2R in patients with RCC was 496.5 U/ml as compared with 302.7 U/ml in the control group (p = 0.056). Pre-operative sIL-2R values were 411.1 U/ml in stage I (n = 6), 481.4 U/ml in stage III (n = 11) and 1, 330 U/ml in stage IV (n = 1). There was no significant difference between stage I and stage III. As compared with pathologic grading, pre-operative sIL-2R levels in patients with grade 2 were significantly higher than those with grade 1 (609.8 U/ml versus 288.7 U/ml, p = 0.016). There existed a significant correlation between preoperative sIL-2R and presumptive tumor volume (r = 0.61, p = 0.008). Three months after surgery, sIL-2R values were significantly higher than before surgery. Serum sIL-2R levels seemed to bear some relationship to the extent of disease in patients with RCC. Values of sIL-2R were significantly higher after than before surgery at least for a three-month postoperative period, suggesting a response to trauma of surgery. Further long term studies were required to clarify if sIL-2R could predict the progression of disease.