Yanagitani Noriko, Kaira Kyoichi, Sunaga Noriaki, Naito Yoichi, Koike Yoko, Ishihara Shinichi, Ishizuka Tamotsu, Saito Ryusei, Mori Masatomo
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Int J Clin Oncol. 2007 Jun;12(3):231-3. doi: 10.1007/s10147-006-0643-9. Epub 2007 Jun 27.
A 68-year-old male smoker was diagnosed as having amylase-producing small-cell lung cancer (SCLC). The serum amylase level was elevated, at 1756 IU/l, and the isozyme pattern was salivary type. Serum levels of "the tumor markers" CEA and NSE were 10.0 ng/ml and 22.6 ng/ml, respectively, but the level of pro-GRP was within the normal range. He was treated with combination chemotherapy of carboplatin and irinotecan. After completion of the chemotherapy, the serum amylase level decreased below the cutoff range and a computed tomography (CT) scan of the chest revealed marked reductions of the tumor in the primary site and in the lymph node metastasis. In November 2003, he was noted to have a slightly raised amylase level, of 168 IU/l, and raised levels of tumor markers. At this time, a CT scan, bone scintigraphy, and magnetic resonance imaging (MRI) of the brain demonstrated no recurrence. However, in December, MRI of the brain showed multiple metastases, and the recurrence of SCLC was thus confirmed. For the treatment of disease progression, the same regimen of chemotherapy as that given initially was administered. CT imaging revealed a partial response in the primary site and lymph node metastasis, and the serum amylase level decreased to 91 IU/l. After the completion of the second chemotherapy regimen, he underwent cranial irradiation and further chemotherapy. However, unfortunately, he died owing to deterioration of lung cancer. In this patient, the serum amylase level was found to be a highly sensitive marker of lung cancer.
一名68岁男性吸烟者被诊断为产生淀粉酶的小细胞肺癌（SCLC）。血清淀粉酶水平升高，为1756 IU/l，同工酶模式为唾液型。血清“肿瘤标志物”癌胚抗原（CEA）和神经元特异性烯醇化酶（NSE）水平分别为10.0 ng/ml和22.6 ng/ml，但胃泌素释放肽前体（pro-GRP）水平在正常范围内。他接受了卡铂和伊立替康的联合化疗。化疗结束后，血清淀粉酶水平降至临界值以下，胸部计算机断层扫描（CT）显示原发部位和淋巴结转移灶的肿瘤明显缩小。2003年11月，他的淀粉酶水平略有升高，为168 IU/l，肿瘤标志物水平也升高。此时，脑部CT扫描、骨闪烁显像和磁共振成像（MRI）均未显示复发。然而，12月时，脑部MRI显示多发转移，从而确诊为SCLC复发。为治疗疾病进展，给予了与最初相同的化疗方案。CT成像显示原发部位和淋巴结转移灶有部分缓解，血清淀粉酶水平降至91 IU/l。第二个化疗方案结束后，他接受了颅脑放疗及进一步化疗。然而，不幸的是，他因肺癌恶化而死亡。在该患者中，血清淀粉酶水平被发现是肺癌的一个高度敏感标志物。
