前立腺癌における腫瘍マーカーの臨床的検討 — Prostatic acid phosphatase , Prostatic antigen,γ-Seminoprotein の同時測定による検討 -

Abstract

未治療前立腺癌58例, 未治療前立腺肥大症77例, 男子非前立腺尿路性器疾患57例を対象として従来のPAPにPAあるいはγ-SMを加え, その臨床的意義を検討した.前立腺癌以外の疾患ではPAPの他に他のマーカーを加えても診断的意義はあまり変わらなかった.前立腺癌low stage群では他のマーカーにより陽性率の上昇が得られ, PAやγ-SMの追加が臨床経過のモニター上有用と思われた.一方high stage群では, 3つの陽性率がかなり重なり合い, 追加測定によって得られる陽性率の上昇はlow stage群にに比し低かった.PAP, PA, γ-SMの同時測定では, 複数のマーカーが陽性となる割合は前立腺癌以外では極めて低く, この結果からは複数のマーカーが同時に陽性となることが前立腺癌の存在を強く疑う所見となると思われた

Measurements of prostatic acid phosphatase (PAP), prostatic antigen (PA) and gamma-seminoprotein (gamma-Sm) have been found to be clinically useful in the diagnosis of prostatic carcinoma, but, the usefulness of simultaneous measurement has not yet been elucidated. We determined the clinical significance of simultaneous measurement of these markers, especially, the additional measurement of PA or gamma-Sm to PAP in prostatic carcinoma. Each measurement of PAP, PA and gamma-Sm yielded a very low "false" positive rate (0-6.5%) in patients with non-prostatic urogenital disease or benign prostatic hypertrophy (BPH), which was consistent with the results reported so far by other researchers. Eighteen patients with newly diagnosed prostatic carcinoma of a low stage showed a positive rate of PAP in 16.7%, PA in 33.3% and gamma-Sm in 38.9%. Forty patients having a high stage had a positive rate of 67.5% for each of the markers. In patients with BPH, the positive rate was elevated in only 2.6, 5.2 or 3.9% by the additional measurement of PA or gamma-Sm to PAP, or that of gamma-Sm to PA, respectively. This implied that the additional measurement of other markers to PAP or PA produced only a low elevation of the "false" positive rate. The positive rate in patients with prostatic carcinoma of low stage was increased by the additional measurement of PA or gamma-Sm to PAP or that of gamma-Sm to PA. This suggests that in patients with low stage carcinoma, assay with these combinations would be clinically useful to monitor the patient's clinical course.(ABSTRACT TRUNCATED AT 250 WORDS)