前立腺癌に関する研究 2.骨髄血中酸性フォスファターゼ活性値について

Abstract

Acid phosphatase activities of the bone marrow and peripheral serum were measured in the patients with carcinoma of the prostate or benign hyperplasia diagnosed at the Department of Urology, Hiroshima University Hospital. The enzyme levels were comparatively examined with bone x-rays and bone scintigrams. 1) Three cases of benign hyperplasia all showed normal peripheral and bone marrow serum acid phosphatase activity. 2) In five cases (41.7%) of 12 stage C carcinoma of the prostate, prostatic acid phosphatase of the bone marrow-l was elevated. Two (11.8%) of stage D carcinoma showed normal range of the same phosphatase probably due to antiandrogenic treatment progressing. 3) Those without radiological metastasis to the bone showed the prostatic acid phosphatase level of the bone marrow significantly higher than that of the peripheral serum. The patients with radiological metastasis showed no difference between both compartments. 4) In the patients without radiological metastasis to the bone, total acid phosphatase of the bone marrow-1 was elevated in 6 (37.5%) of 16 cases having normal total serum acid phosphatase. The prostatic acid phosphatase of the bone marrow-l was elevated in 2(18.2%) of 11 cases having normal prostatic acid phosphatase level. 5) In 2 (16.7%) of 12 cases lacking of x-ray finding of the bone metastasis, the bone metastasis was detected in bone scintigraphy. 6) In 2 (20.0%) of 10 cases free of metastatic finding in bone scintigraphy, the total acid phosphatase of the bone marrow-1 was elevated. One of them developed bone metastasis on the repeated bone scintigraphy three months later. 7) Death within two years was experienced in 4 (36.4%) of 11 cases without radiological bone metastasis, in 2 (25.0%) of 8 cases having normal prostatic acid phosphatase level, in 2 (22.2%) of 9 cases free of metastasis on bone scintigraphy, 2 (25.0%) of 8 cases having normal total acid phosphatase level of the bone marrow-1 and in one (20.0%) of 5 cases having normal prostatic acid phosphatase of the bone marrow-I. From the above results, it is stressed that measurement of acid phosphatase of the bone marrow is one of the more sensitive examinations compared with x-ray, scintigraphic or serum acid phosphatase study. Clinical application of it would contribute to the early diagnosis and prognostic evaluation of the disease.