Ishigaki H, Satoh S, Saitoh S, Yoshida Y, Ebina T, Satoh T, Nara K, Asano M, Oh-ishi S, Satoh F
First Dept. of Internal Medicine, Hirosaki Univ. School of Med.
Gan To Kagaku Ryoho. 1989 Dec;16(12):3805-8.
An autopsy case of a 57-year-old man who had received cisplatin, total dose of 3,250 mg (1,920 mg/m2) after proctectomy for advanced rectal cancer with hepatic metastasis is reported. Platinum concentrations in autopsy tissue samples are also reported. Cisplatin at a dose of 20-40 mg was administered intravenously once a week for 82 weeks, but renal failure did not occur. The patient died 529 days after his last cisplatin therapy, due to acute suppurative cholangitis. On autopsy, the hepatic hilar metastasis involved the bile duct, but the other metastasis of the liver became regeneration and necrosis, and the kidneys showed few findings but congestion and arteriosclerotic change. The spleen evidenced mild hemosiderosis. Tissue samples obtained at the time of autopsy were assayed for platinum using flameless atomic absorption spectrometry. The spleen had the highest concentration, about 2.7 times as high as that of the liver. The liver, the heart and the kidneys had high platinum concentrations (greater than 3.04 micrograms/g), but those of the jejunum and the ileum were low (less than 0.95 micrograms/g). Although cisplatin, FT 207 and krestin were effective for the rectal cancer, platinum was undetectable (less than 0.13 micrograms/g) in the ascending and the transverse colons.
报告了一例57岁男性的尸检病例，该患者因晚期直肠癌伴肝转移行直肠切除术后接受了顺铂治疗，总剂量为3250mg（1920mg/m²）。还报告了尸检组织样本中的铂浓度。顺铂剂量为20 - 40mg，每周静脉注射一次，共82周，但未发生肾衰竭。患者在最后一次顺铂治疗后529天因急性化脓性胆管炎死亡。尸检时，肝门转移累及胆管，但肝脏的其他转移灶出现再生和坏死，肾脏除充血和动脉硬化改变外未见其他明显病变。脾脏有轻度含铁血黄素沉着。尸检时获取的组织样本采用无火焰原子吸收光谱法检测铂含量。脾脏中的铂浓度最高，约为肝脏的2.7倍。肝脏、心脏和肾脏的铂浓度较高（大于3.04微克/克），但空肠和回肠的铂浓度较低（小于0.95微克/克）。尽管顺铂、FT 207和云芝多糖对直肠癌有效，但在升结肠和横结肠中未检测到铂（小于0.13微克/克）。
