腎癌におけるImmunosuppressive Acidic Protein(IAP)とImmunosuppressive Substance(ISS)の検討

Abstract

腎癌症例においてIAPとISSを測定し, その腫瘍マーカーとしての意義を検討した.1) IAP, ISSとも各stage別の平均値は正常上限値を上回り, 特にM1群で高値を示した.また両者の実測値は非常によく相関した.2)両者ともstageの進行に伴ってその陽性率は上昇した.3)両者とも臨床経過とある程度相関して変動した.4)有転移症例において, 正常上限値の2倍以上の高値群は2倍以下の群に比して, 予後不良な傾向が両者ともに認められた.以上より, IAP, ISSは腎癌における腫瘍マーカーとして有用である.5) IAPもしくはISSとTPA, ferritinの三者でのcombination assayは臨床的に有意義である

To clarify their usefulness as markers for renal cell carcinoma, serum immunosuppressive acidic protein (IAP) and serum immunosuppressive substance (ISS) were evaluated by TIA (turbidometric immunoassay) for IAP and by SRID (single radial immunodiffusion) for ISS. The mean level of IAP and ISS was beyond each upper normal limit (500, 700 micrograms/ml) in every stage, and especially high in the M1 group. The levels of IAP and ISS were significantly correlated with each other. The determination of IAP and ISS levels after treatment showed a good correlation to the clinical course of the disease. The positive rates of IAP and ISS increased as the stages progressed, respectively. When the influences of pretreatment IAP and ISS level on survival period were investigated, the low IAP or ISS level group (less than two times of the upper normal limit) tended to have a better prognosis than the high level group (more than two times of the upper normal limit) in the M1 patients. These findings suggested that IAP and ISS could be used as markers for monitoring a disease and predicting the prognosis in patients with renal cell carcinoma. As for the positive rate in the combination assay for IAP, TPA and ferritin, or ISS, TPA and ferritin, more than 80% of the patients with low stage renal cell carcinoma had at least one positive marker. This suggested that the combination assay of these three markers was clinically valuable as a disease monitor in patients with renal cell carcinoma.