膀胱腫瘍におけるThomsen-Friedenreich antigenに関する研究

Abstract

MN型血液型抗原のprecursorであるThomsen-Friedenreich antigen (T-Ag)の膀胱腫瘍でのマーカーとしての有用性を検討した.1)非悪性腫瘍例は, 全例T-Ag陰性であったが, sialidase処理で脱シアル化すると, T-Agが出現し, cryptic T-Ag陽性であった.2)膀胱腫瘍例では72例中37例は非悪性腫瘍例と同様cryptic T-Ag陽性であったが, 他の35例はT-Ag陽性またはcryptic T-Ag陰性で, 癌性の細胞膜上の糖鎖不全を示唆した.3)腫瘍例では, T-Ag陽性あるいはcryptic T-Ag陰性例はhigh gradeほど高頻度にみ, grade間に相関傾向をみた.4)腫瘍例中, 初回治療をTUR-Btで行った55例での再発は, cryptic T-Ag陽性例に比べ, T-Ag陽性あるいはcryptic T-Ag陰性例は有意に高率で, さらに再発までの期間, すなわちdisease free intervalが短期間であった.5) TUR-Bt後に最終的に, 膀胱全摘術をした6例中5例は, 初回TUR-Bt時よりすでに通常のT-Ag抗原性が消失した.以上より, T-Agおよびその潜在性抗原cryptic T-Agは, 膀胱腫瘍のTUR-Bt後のclinical courseを予測する一指標とし有用と考えた

The presence of Thomsen-Friedenreich antigen (T-Ag) against bladder mucosa in bladder tumor cases and control individuals was examined by the immunoperoxidase and the immunofluorescein method using labelled lectin. T-Ag was negative in all 15 cases of non-malignant bladder epithelium, and positive on the cell surface after sialidase treatment (cryptic T-Ag positive). In the 37 out of 72 bladder tumor cases, however, cryptic T-Ag was positive, and in the remaining 35 cases T-Ag was positive or negative after sialidase treatment. Furthermore 55 cases which had received the first treatment by TUR-Bt were investigated. Thirteen of the 31 cryptic T-Ag positive cases recurred during observation after operation whereas 22 of the 24 T-Ag positive or cryptic T-Ag negative cases recurred, the rate being significantly higher for the latter. In addition, the disease-free interval was absolutely longer in the cryptic T-Ag positive cases than in T-Ag positive or cryptic T-Ag negative cases. The exploration of T-Ag in bladder cancer may be valuable for predicting the clinical course after TUR-Bt.