血清BasicFetoproteinの尿路性器癌に対する臨床的有用性と,移植腎拒絶反応への新しいmonitoring手段としての可能性について

Abstract

対象疾患は尿路性器癌55例, 非癌泌尿器科疾患62例で, 正常対照として腎移植donorの予定者7例のみをこれに充てた.尿路性器癌の内訳は腎癌21例, 腎盂・尿管腫瘍5例, 膀胱腫瘍22例, 前立腺癌3例, 精巣腫瘍4例で, 腎移植は17例(急性拒絶反応8例, 慢性拒絶反応3例, 非拒絶時6例)である.1)癌疾患では, 未治療の腎癌が40.0%, 膀胱癌が21.1%のBFP陽性率を示し, 再燃癌では55.6%の陽性率であった.いずれも, 腫瘍の進展とともに陽性率の上昇する傾向がある一方, 手術・化学療法などの治療により, 陽性例のBFPのすみやかな低下がえられ, 治療経過のモニターとしての有用性が期待された.2)腎移植症例では, 拒絶反応と血清BFPとがきわめて高い相関が示し, 血清BFPが拒絶反応に対する新しいモニターとなりうることが示唆された

The serum basic fetoprotein (BFP) in patients with urogenital diseases was measured by enzyme immunoassay (EIA). The positive range of serum BFP was defined to be 75 ng/ml or more. In benign cases except for renal transplantation, the positive rate of serum BFP was 11.1% (5/45), and relatively high (21.4%, 3/14) in benign prostatic hypertrophy. In cases of urogenital cancers before treatment, the positive rate of serum BFP was 29.1% (16/55), and increased with the progression of clinical stage. Eleven of the patients with positive serum BFP before treatment were re-examined after treatment, and all of them exhibited a marked decrease of the titer of serum BFP. In seventeen renal transplant patients, the positive rate of serum BFP was 100% (8/8) in acute rejection, 66.7% (2/3) in chronic rejection and 0% (0/6) in rejection-free condition. We conclude that serum BFP is a clinically beneficial marker for renal transplant rejections and urogenital malignancies.