睾丸腫瘍の化学療法時におけるα-Fetoprotein(AFP)偽陽性について

Abstract

1) VAB-6(Vinblastine, actinomycin D, Bleomycin, cyclophosphamide, cisplatinum)療法を行なった症例で, GOT, GPT, LDH, γ-GPTなどの上昇と平行したAFPの一過性の上昇を経験した.2) 1979年より1984年まで当教室で治療した進行性睾丸腫瘍11例につき, PVB療法, salvage療法, VAB-6療法のそれぞれによる肝障害の有無につき検討した.VAB-6療法症例ではGOT, GPT, LDHは化療後有意に上昇しており, 治療前正常であったAFPも治療後有意に上昇していた.3) VAB-6療法後のAFPの一時的軽度の上昇は一過性の肝機能障害と強く相関していた.4)一部の症例ではAFPのconcanavalin Aへの吸着性の検討が可能であり, 治療前正常であったAFPの一過性の上昇は肝臓由来と思われた

During induction chemotherapy, we experienced the false elevation of the tumor marker alpha-fetoprotein (AFP) in some disseminated testicular cancer patients. We discussed the possibility of the false elevation of the tumor marker AFP and evaluated the relationship between AFP and the markers of liver damage (GOT, GPT, LDH, etc.), the elevation of which were caused by induction chemotherapy of the VAB-6 regimen. We evaluated each variable of the eleven patients with disseminated testicular cancer who had been treated in our hospital between 1979 and 1984. The elevation of each marker of liver damage was induced by the VAB-6 regimen, immediately after the end of each induction chemotherapy but not by other induction chemotherapy regimens. A statistical study confirmed that there was a close correlation between the elevation of AFP and of the markers of liver damage, that is induced frequently by the induction chemotherapy of VAB-6 regimen.