泌尿器科領域の悪性腫瘍における癌胎児性抗原(carcinoembryonic antigen) 第1報: 臨床的意義

Abstract

Radioimmunoassay for plasma carcinoembryonic antigen (CEA) was performed in 163 patients with urologic cancer, also in 58 control cases consisting of 42 non-cancerous urologic diseases and 16 normal and healthy subjects. In 58 control patients, the plasma CEA was 3.1 ± 1.9ng/ml. On the basis of this experiment, the positive plasma CEA level was designated as above 6ng/ml.., therefore among the 58 control patients, positive plasma CEA was found in 8.6%. Out of 163 patients, 59 patients (92 samples) had, at the time of assay, bladder cancer and the plasma CEA values were 6.8 ± 4.9ng/ml. After treatment, 55 patients (74 samples) became free of bladder cancer and the plasma CEA values were 3.1 ± 1.9ng/ml. The comparison was significant (p<0.001). Of 59 patients with bladder cancer, the plasma CEA was high in 42 (45.6%) of 92 samples. In 55 patients who had treatment the plasma CEA was high in only 9(12.1 %, ) of 74 samples after operation. Again, the difference was significant (p<0.01). Sixteen patients with renal pelvic and ureteral cancer, the plasma CEA values were 6.8 ± 5.4 ng/ml. After treatment there were 8 patients free of renal pelvic and ureteral cancer and their plasma CEA values were 3.5 ± 2.8ng/ml. In 58 control patients, the values were 3.1 ± 1.9ng/ml. The difference was significant (p<0.001). Therefore, the plasma CEA was high in 8(50%) of 16 patients with renal and ureteral cancer, but after treatment only one (12.5%, ) was high out of 8 patients. There was a significant difference between renal pelvic and ureteral cancer and the control patients (p<0.001), but 8 patients without the cancer after treatment showed no difference. In 22 patients with renal cancer, the plasma CEA values were 5.7 ± 4.6ng/ml. After treatment, 9 patients without renal cancer showed the plasma CEA values 2.8 ± 1.3 ng/ml.!. The difference was not significant. The incidence of CEA-positive cases in renal cancer was 36.3%" but, after treatment 9 patients free of renal cancer were all CEA-negative. In 9 patients with prostatic cancer, the plasma CEA was 6.0±4.9ng/ml. This value was significantly high (p<0.01). Whereas in 11 patients with well controlled prostatic cancer the plasma CEA were 3.2 ± 1.5ng/ml. Of 9 patients with prostatic cancer, 3 were CEA-positive (33.3%), on the other hand 11 patients with well-controlled prostatic cancer were all CEA-negative. Of 58 control patients, 14 had benign prostatic hypertrophy in which plasma CEA was 3.6 ± 2.0ng/ml. and only two (14.2%) were CEA-positive. Out of remaining 9 patients with other urologic cancers, 2 penile cancer and one testicular cancer showed positive results. The values of CEA in the urologic malignancies with metastases were 10.8 ± 7.2ng/ml in bladder cancer and 11.1 ± 6.6ng/ml in pelvic and ureteral cancer. On the other hand, those who had no metastatic lesion showed CEA values as low as 6.3 ± 4.4ng/ml in bladder cancer and 4.8 ± 3.4ng/ml in pelvic and ureteral cancer. The difference was significant (p<0.05). There was no direct correlation, between the stage or grade and plasma CEA in 51 bladder cancer patients. In the treatment of urologic cancer patients, the plasma CEA appeared to be useful in the follow up, also, in evaluating effects after treatment, especially in bladder, renal pelvic, ureteral and prostatic cancer patients.