Löser C, Fölsch U R, Paprotny C, Creutzfeldt W
Department of Medicine, Georg August-University of Göttingen, FRG.
Cancer. 1990 Feb 15;65(4):958-66. doi: 10.1002/1097-0142(19900215)65:4<958::aid-cncr2820650423>3.0.co;2-z.
Total, free, and acetylated polyamine concentrations were measured simultaneously in colon tissue, serum, and urine of 50 patients with histologically proven colorectal cancer, 40 patients with nonmalignant gastrointestinal diseases, and 30 healthy volunteers. Compared with histologically unaffected colon tissue, concentrations were significantly (P less than 0.001) higher for putrescine, elevated for cadaverine, and nearly identical for spermidine and spermine in colon carcinoma, whereas N1-acetylated and N8-acetylated spermidine were detectable in cancer tissue only. Serum and urine concentrations of all polyamines except total cadaverine and spermine in serum and free spermine in urine were significantly elevated compared with healthy controls and highest sensitivity for colon cancer was found for total spermidine (89.15%) in serum and acetylputrescine (84.5%), total putrescine (84.0%), N1-acetylspermidine (79.3%), and total spermidine (92.1%) in urine. However, nonmalignant gastrointestinal diseases partly showed similar elevations which resulted in a low specificity for polyamines in colorectal cancer. Therefore, polyamines are of little value only as diagnostic markers in colorectal carcinoma. Since polyamine concentrations in serum and urine normalized in patients after curative operation while they were further elevated in patients with proven tumor relapse or metastases, these substances might play a clinical role in predicting therapeutic success or indicating relapse of the tumor. Although a significant dependency of polyamine concentrations in serum or urine to Dukes' classification, tumor localization, CEA, CA 19-9, or CA 125 did not exist, a significant linear correlation was found for tumor size.
对50例经组织学证实的结直肠癌患者、40例非恶性胃肠道疾病患者和30名健康志愿者的结肠组织、血清和尿液中的总多胺、游离多胺和乙酰化多胺浓度进行了同时测定。与组织学未受影响的结肠组织相比，结直肠癌组织中腐胺浓度显著升高（P<0.001），尸胺浓度升高，亚精胺和精胺浓度几乎相同，而仅在癌组织中可检测到N1-乙酰化和N8-乙酰化亚精胺。与健康对照相比，除血清中总尸胺和精胺以及尿液中游离精胺外，所有多胺的血清和尿液浓度均显著升高，血清中总亚精胺（89.15%）、尿液中乙酰腐胺（84.5%）、总腐胺（84.0%）、N1-乙酰亚精胺（79.3%）和总亚精胺（92.1%）对结肠癌的敏感性最高。然而，非恶性胃肠道疾病部分显示出类似的升高，导致多胺对结直肠癌的特异性较低。因此，多胺仅作为结直肠癌的诊断标志物价值不大。由于根治性手术后患者血清和尿液中的多胺浓度恢复正常，而肿瘤复发或转移患者的多胺浓度进一步升高，这些物质可能在预测治疗成功或提示肿瘤复发方面发挥临床作用。虽然血清或尿液中的多胺浓度与Dukes分期、肿瘤定位、癌胚抗原（CEA）、糖类抗原19-9（CA 19-9）或糖类抗原125（CA 125）之间不存在显著相关性，但发现与肿瘤大小存在显著线性相关。
