CEAとCA19-9が高値を示した前立腺癌の1例

Abstract

症例は80歳男で, 食欲不振を主訴とする.入院時血清CEA, CA19-9, 血清PSAは高値を示していた.CTにて大動脈周囲のリンパ節腫脹を認め, 骨シンチでは多発性骨転移を認めた.前立腺針生検で悪性所見を認めなかった.前立腺癌が疑われ, 内分泌療法を開始したが, 2ヵ月後に死亡した.剖検試料は組織学的に前立腺癌(低分化型腺癌)であり, 肺, 肝, 甲状腺, 骨髄, 副腎に転移を認めた

We report a case of primary adenocarcinoma of the prostate cancer producing carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). An 80-year-old man admitted to our hospital with the complaint of appetite loss. Serum CEA and CA19-9 levels were increased to 28.9 ng/ml (normal < 3.5) and 271 U/ml (normal < 37), respectively. Serum PSA level was also high (33 ng/ml; normal < 3.6). Computed tomography (CT) demonstrated para-aortic lymph node swelling and bone scan revealed multiple bone metastasis. Prostate biopsy was performed and the specimen showed no evidence of malignancy. However endocrine therapy was started because of the strong suspicion of prostate cancer. In spite of the treatment, the patient died 2 months after the treatment. Histology of autopsy specimen demonstrated primary prostate cancer (poorly differentiated adenocarcinoma) and metastases to multiple organs, such as lungs, liver, thyroid, bone marrow and adrenals. Immunohistochemical staining for CEA, CA19-9 and PSA demonstrated the existence of each protein at both primary and metastatic sites.