前立腺癌の再燃と腫瘍マーカー

Abstract

1979年1月～1990年3月までの再燃27例を対象に検討した.1)再燃は局所3例・全身8例・合併16例で, 2)再燃時腫瘍マーカー上昇の先行例11で全身例6, 3)再燃時PAP-RIA:21/27例・γ-Sm:15/18例・PAは12/15例で陽性となり, マーカー3種の陽性はほぼ同時期であった

Twenty-seven cases of reactivated prostatic cancer between 1979 and 1990 were investigated. Reactivation took place in the form of local aggravation in 3 cases, occurrence or aggravation of metastasis to bones in 8 cases, and in both forms in 16 cases. The elevation of tumor markers preceded the clinical findings in 11 cases (41%). In 75% of the cases with occurrence or aggravation of metastasis, the elevation of tumor markers preceded the clinical findings. This showed that tumor markers were useful in most cases for early detection of reactivation. However, in 3 cases with local aggravation, the clinical findings preceded the elevation of tumor marks. Therefore, it is also important to check the clinical findings at the follow-up. At the time of reactivation, positive rates of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostatic specific antigen (PA) were 78%, 83% and 80%, respectively. Thus gamma-Sm and PA appeared to be more reliable than PAP for monitoring of prostatic cancer.