泌尿器科癌に対する抗癌剤投与時にみられる腎機能障害を反映する尿中パラメーターの比較検討

Abstract

抗癌剤投与による尿細管障害を尿中酵素・蛋白から判断する時には, 今回の検討からは, β2-Mを指標にするのが最も良いと思われた。β2-Mは変動幅がもっとも鋭敏であり, 他の酵素や蛋白に比べ反応の早期出現性にも問題がなくもっとも良いパラメーターと思われた

We analyzed the excretion of the three urinary enzymes, N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase (AAP), and glycyl-prolyl dipeptidyl aminopeptidase (GP-DAP) and the three urinary proteins, beta-microglobulin (beta 2-M), alpha-microglobulin (alpha 1-M), and albumin during the intravenous administration of anti cancer drugs in 4 prostatic cancer patients and 16 urothelial cancer patients. The patients with prostatic cancer were treated with VIP (vincristine, ifosfamide, peplomycin) chemotherapy and the patients with urothelial cancer were treated with MP (methotrexate, cisplatinum) or MEP (methotrexate, Etoposide, cisplatinum) combination chemotherapy. beta 2-M was the best parameter for drug-induced renal damage because of its sharp and large reactivities. Any urinary enzyme or protein especially albumin which had showed a markedly high value before the chemotherapy was not suitable as a urinary drug-induced renal damage parameter. There was a close resemblance in reactivity pattern between GP-DAP and AAP probably because of the same localization of these enzymes in the renal tubular bruch borders. In the patients with renal damage by chemotherapy, all parameters were changed showing two peaks or persisted with high values.