Sanada S, Ogura K, Kiriyama T, Yoshida O
Hinyokika Kiyo. 1985 Aug;31(8):1299-316.
Recently, the study of the physiological role of the essential trace elements is being emphasized. Some environmental and disease factors has been demonstrated to perturb trace element homeostasis. A number of recent studies have described alterations in serum copper levels (SCLs) and serum zinc levels (SZLs) in human cancer patients and the relationship between the magnitude of their perturbation and disease activity. This report describes SCLs, SZLs and SCL/SZL ratios in patients with malignant neoplasms of the urogenital tract at various clinical stages and the relationship of the levels of these trace elements to disease activity. According to SCLs before treatment, patients with renal cell carcinoma appeared to be separated into two groups, normal SCL group and higher SCL group. In the higher SCL group, patients generally displayed increased erythrocyte sedimentation rate, CRP, alpha 2 globulin, beta 2 microglobulin, ferritin and CEA. In this group, SCL was a useful index of disease activity. In the normal SCL group, SCLs remained within normal limit even in patients with advanced disease. In renal cell carcinoma, SZLs did not reflect disease activity. In transitional cell carcinoma of the upper urinary tract, patients with metastasis had significantly elevated SCLs and significantly decreased SZLs, compared with normal controls or patients without metastasis. In transitional cell carcinoma of the bladder, no distinct relationships were observed between these trace elements and extent of malignancy. But there was a trend toward increasing SCLs and decreasing SZLs with progressing stage and SCL/SZL ratios fairly reflect stage of disease. Patients with prostatic cancer had nearly normal SCLs and SZLs, although there were a few exceptions. Testicular cancer patients with distant metastasis had significantly elevated SCLs and initially high SCLs decreased in patients responding to therapy and increased again in relapse. SZLs and, hence, SCL/SZL ratios had no relationship to activity of testicular cancer. Currently there is no satisfactory way of following the progress of malignancies of the urogenital tract except prostatic cancer with elevated acid phosphatase and non-seminomatous testicular tumors until the secondary tumor can be detected radiographically. Our study suggests that these trace element might be a useful indicator of disease activity of some of the urogenital malignancies.
最近,必需微量元素的生理作用研究受到重视。一些环境和疾病因素已被证明会扰乱微量元素的稳态。最近的一些研究描述了人类癌症患者血清铜水平(SCLs)和血清锌水平(SZLs)的变化,以及它们的扰动程度与疾病活动之间的关系。本报告描述了不同临床阶段泌尿生殖道恶性肿瘤患者的SCLs、SZLs和SCL/SZL比值,以及这些微量元素水平与疾病活动的关系。根据治疗前的SCLs,肾细胞癌患者似乎可分为两组,即SCL正常组和SCL较高组。在SCL较高组中,患者通常表现为红细胞沉降率、C反应蛋白、α2球蛋白、β2微球蛋白、铁蛋白和癌胚抗原升高。在该组中,SCL是疾病活动的一个有用指标。在SCL正常组中,即使是晚期疾病患者,SCLs仍保持在正常范围内。在肾细胞癌中,SZLs不能反映疾病活动。在上尿路移行细胞癌中,与正常对照组或无转移患者相比,有转移的患者SCLs显著升高,SZLs显著降低。在膀胱移行细胞癌中,未观察到这些微量元素与恶性程度之间有明显关系。但随着疾病进展,有SCLs升高和SZLs降低的趋势,且SCL/SZL比值相当能反映疾病分期。前列腺癌患者的SCLs和SZLs几乎正常,不过也有一些例外情况。有远处转移的睾丸癌患者SCLs显著升高,对治疗有反应的患者最初较高的SCLs会下降,复发时又会再次升高。SZLs以及SCL/SZL比值与睾丸癌的活动无关。目前,除了酸性磷酸酶升高的前列腺癌和非精原细胞瘤性睾丸肿瘤外,在继发肿瘤能够通过影像学检测到之前,没有令人满意的方法来跟踪泌尿生殖道恶性肿瘤的进展。我们的研究表明,这些微量元素可能是一些泌尿生殖道恶性肿瘤疾病活动的有用指标。