血清Tissue Polypeptide Antigenの尿路性器癌における腫瘍マーカーとしての意義 : 特に腎癌,前立腺癌における他の腫瘍マーカーとの比較検討

Abstract

尿路性器癌患者124例を中心に血清TPA値を測定し, その腫瘍マーカーとしての意義を検討した.1)各悪性腫瘍におけるs-TPA値の平均は膀胱癌207±246 U/l, 腎盂癌197±52 U/l, 腎癌187±156 U/l, 前立腺癌167±183 U/l, 睾丸腫瘍95±28 U/lであった.2)各悪性腫瘍におけるs-TPA値の陽性率は腎盂癌100%, 腎癌68%, 膀胱癌57%, 前立腺癌52%, 睾丸腫瘍13%であった.3)急性尿路感染症を起こしている症例ではs-TPA値は高値を示す傾向がみられた.4)腎癌および前立腺癌においてはs-TPA値は臨床経過とよく相関し, 治療効果を反映しうると考えられた.5)腎癌においてs-TPAはs-ferritinよりも陽性率は高かったが, 両者とも臨床経過とよく相関した.6)前立腺癌においてs-TPAは陽性率でPAP, γ-Sm, PAよりもやや下回り, また治療開始後の正常化率にても他の3者よりも低かった

Serum tissue polypeptide antigen (s-TPA) levels were determined in 124 patients having urogenital carcinomas, 74 with benign urological diseases and 55 normal subjects. We analyzed these results and determined the clinical significance of s-TPA as a tumor marker for urogenital carcinomas. S-TPA levels in the 55 normal subjects was 80 +/- 17 U/L (mean +/- S.D.). Since more than 95% of them showed an s-TPA level of below 110 U/L, this level was used as the cut-off value. The s-TPA level was 125 +/- 75 U/L for the 42 patients with benign prostatic hypertrophy, 138 +/- 60 U/L for the 15 patients with acute urinary tract infections (UTI) and 80 +/- 20 U/L in the 17 patients having other benign urological diseases. An elevated s-TPA level was clearly demonstrated in the case of acute UTI, which displayed a false positive result. The s-TPA level was 207 +/- 246 U/L for the 21 patients with bladder carcinoma, 197 +/- 52 U/L for the 5 patients with renal pelvic or ureteral carcinoma, 187 +/- 156 U/L for the 22 patients with renal cell carcinoma, 167 +/- 183 U/L for the 46 patients with prostatic carcinoma, and 95 +/- 28 U/L for the 8 patients with testicular carcinoma. In the 8 patients having bladder carcinoma, the elevation of s-TPA level seemed to be caused by the concomitant presence of acute UTI. The positive rate of s-TPA in various urogenital carcinomas was 100% for renal pelvic or ureteral carcinoma, 68% for renal cell carcinoma, 59% for bladder carcinoma, 52% for prostatic carcinoma and 13% for testicular carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)