前立腺肥大症,偶発前立腺癌における前立腺腫瘍マーカーと臨床・病理学的所見の関連について

Abstract

前立腺肥大症81例, 偶発前立腺癌12例について前立腺腫瘍マーカーを測定し検討した.1)前立腺肥大症においてγ-Smが偽陽性を示した割合は21例でありPAP 3例, PSA 6例に比べて高かった.2)マーカーが偽陽性を示す前立腺肥大症は大きく, 組織学的に腺構造の成分が多かった.3)急性前立腺炎, 急性尿閉, 壊死のあるものはマーカーが上昇した.4)偶発癌ではマーカーが複数上昇する症例の割合が, 前立腺肥大症に比べて高かった.5)前立腺癌ではマーカーが上昇しないものもあるので診断に際して注意が必要である

To determine the value of prostatic markers for prostate cancer, serum prostatic acid phosphatase (PAP), prostate specific antigen (PSA) and gamma-Seminoprotein (gamma-Sm) were measured in 81 patients with benign prostatic hypertrophy and in 12 patients with incidental prostatic cancer. gamma-Sm was the most sensitive but the least specific of the three markers. Large prostate glands, especially hyper-glandular type tended to be associated with high gamma-Sm levels in our study. Patients with acute urinary retention, acute prostatitis and necrosis also showed positive markers. Out of 12 patients with incidental cancer, 5 patients had more than 2 elevated markers. Four patients with poorly differentiated adenocarcinoma failed to show increased markers.