前立腺癌凍結手術療法後の腫瘍マーカーの変動

Abstract

Stage Bまでの未治療前立腺癌患者に凍結手術を施行し, 前立腺癌腫瘍マーカーの変動を検討した.1)凍結手術後PAP, γ-Sm, PSAは3ヵ月目まで正常範囲の低い値で経過し, 凍結手術の癌病巣への治療効果が推測された.2)凍結手術後6ヵ月目まで未治療の症例では, PAP, γ-Sm, PSAは正常範囲を越え高値となる傾向があり癌の再熱を思わせた

Cryosurgery is performed in poor risk cases of prostate carcinoma with dysuria. This modality has been reported to reduce the metastatic lesion postoperatively in cases of prostate carcinoma accompanied by metastasis and is employed as an adjuvant therapy of prostate carcinoma. However, many cases are already at an advanced stage and have undergone other therapeutic modalities and as a result the exact role of cryosurgery in prostate carcinoma is not clear. The present investigation was undertaken to clarify the effectiveness of cryosurgery in prostate carcinoma. The patients consisted of 21 untreated cases of histologically confirmed prostate carcinoma admitted our hospital during the 5-year period from December, 1982 to December, 1987, in all of whom treatment by cryosurgery alone was indicated, i.e., up stage B, and in whom changes in prostate carcinoma tumor markers, alkaline phosphatase (ALP), acid phosphatase (ACP), prostatic ACP detected enzymatically (PACP), and by radioimmunoassay (PAP), gamma-seminoprotein (gamma-Sm), and prostate specific antigen (PSA) were measured. During the same period, changes in tumor makers in 11 cases of prostate hypertrophy treated by transurethral resection of prostate (TUR-P) were also examined. The tumor markers were measured prior to cryosurgery and 1, 3, 7 and 14 days postoperatively as well as at 1, 3 and 6 months. Following TUR-P, in the cases of prostate hypertrophy, no postoperative changes in ALP, ACP or PACP were observed but there was elevation of PAP and gamma-Sm at day 1 and elevation of PSA until day 3, but none of these were statistically significant differences.(ABSTRACT TRUNCATED AT 250 WORDS)