Okazaki I, Matsuyama S, Suzuki F, Maruyama K, Maruta A, Kubochi K, Yoshino K, Kobayashi Y, Abe O, Tsuchiya M
Department of Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan.
J Lab Clin Med. 1992 Dec;120(6):908-20.
A method for determining the endogenous urinary excretion levels of both 3-hydroxyproline and 4-hydroxyproline that may be useful for cancer screening of the general population and at the workplace is evaluated in this report. The excretion levels of 3-hydroxyproline and 4-hydroxproline were estimated in 97 patients with cancer and in 99 patients with various nonmalignant diseases and were compared with those of 211 healthy persons. Measurable 3-hydroxyproline peaks (by amino acid autoanalyzer) were absent from 93 samples from 211 healthy persons (44%), 50 of 99 patients with nonmalignant disease (50%), and 10 of 96 patients with cancer (10%). The levels of both 3-hydroxyproline and 4-hydroxyproline in cancer patients were significantly higher than those in healthy persons (p < 0.001 and p < 0.01, respectively) and those in patients with nonmalignant diseases (p < 0.05 and p < 0.01, respectively). Cancer patients were classified into three groups according to grade of cancer growth and invasion. The sensitivity of 3-hydroxyproline was 44% and higher than that of 4-hydroxyproline for the detection of stage II cancers (no distant metastasis); the sensitivities of both hydroxyprolines for the detection of stage I (very early cancer) were low. The specificity of these assays for healthy persons and patients with nonmalignant disease was 96% and 92% for 3-hydroxyproline, and 97% and 79% for 4-hydroxyproline, respectively. Urinary 3-hydroxyproline level should be further investigated as a cancer screening method for healthy persons in the community or the workplace, but appears unlikely to detect many cancers in the earliest stages.
本报告评估了一种测定内源性尿中3-羟脯氨酸和4-羟脯氨酸排泄水平的方法，该方法可能对普通人群和工作场所的癌症筛查有用。对97例癌症患者、99例患有各种非恶性疾病的患者以及211名健康人的3-羟脯氨酸和4-羟脯氨酸排泄水平进行了估计，并进行了比较。在211名健康人的93份样本（44%）、99例非恶性疾病患者的50份样本（50%）和96例癌症患者的10份样本（10%）中，未检测到可测量的3-羟脯氨酸峰（通过氨基酸自动分析仪）。癌症患者的3-羟脯氨酸和4-羟脯氨酸水平均显著高于健康人（分别为p < 0.001和p < 0.01）以及非恶性疾病患者（分别为p < 0.05和p < 0.01）。根据癌症生长和侵袭程度，将癌症患者分为三组。在检测II期癌症（无远处转移）时，3-羟脯氨酸的敏感性为44%，高于4-羟脯氨酸；两种羟脯氨酸对I期（极早期癌症）的检测敏感性均较低。这些检测方法对健康人和非恶性疾病患者的特异性分别为：3-羟脯氨酸为96%和92%，4-羟脯氨酸为97%和79%。尿3-羟脯氨酸水平作为社区或工作场所健康人的癌症筛查方法应进一步研究，但似乎不太可能在最早阶段检测到许多癌症。
