Baskies A M, Chretien P B, Weiss J F, Makuch R W, Beveridge R A, Catalona W J, Spiegel H E
Cancer. 1980 Jun 15;45(12):3050-60. doi: 10.1002/1097-0142(19800615)45:12<3050::aid-cncr2820451229>3.0.co;2-8.
Serum levels of proteins previously shown to be elevated [acute-phase proteins (APP)-haptoglobin, alpha 1-acid glycoprotein, alpha 1-antitrypsin] or depressed (alpha 2 HS-glycoprotein, prealbumin, albumin) in cancer patients were correlated with tumor extent, in vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA), and quantitative delayed hypersensivity (DH) to dinitrochlorobenzene (DNCB) in 147 preoperative patients with operable solid malignancies either confined to the primary site or with regional spread only. Compared to 58 normal controls, levels of the APP were significantly elevated, alpha 2 HS-glycoprotein and prealbumin depressed, and albumin levels unchanged in patients with either local or regional tumors. In patients with normal DH to DNCB, the APP were higher and prealbumin was lower than in controls; in patients with impaired DH to DNCB, haptoglobin and alpha 1-acid glycoprotein were higher and alpha 2 HS-glycoprotein and prealbumin lower than in patients with normal DH to DNCB. Albumin levels did not differ from normals in any of the groups. Serum protein levels appeared to be more related to the immune status of the patient than to tumor extent. The levels of the three APP correlated directly with each other but inversely with alpha 2 HS-glycoprotein and prealbumin; levels of alpha 2 HS-glycoprotein and prealbumin correlated directly with each other. Levels of haptoglobin and alpha 1-acid glycoprotein correlated inversely with LR to PHA; however, levels of alpha 2 HS-glycoprotein correlated directly with LR to PHA, and uniquely the levels of alpha 2 HS-glycoprotein and LR to PHA both showed similar changes for each of the four quantitative levels of DH to DNCB measured in the cancer patients. The data show that the proteins studied, except for albumin, correlate inversely (APP) or directly (alpha 2 HS-glycoprotein and prealbumin) with in vitro and in vivo parameters of cellular immunity. The results provide a rationale for attempts to improve depressed cellular immunity by lowering circulating levels of APP, as is being attempted in ongoing trials using plasmapheresis, and assessing the effect of exogenous alpha 2 HS-glycoprotein or prealbumin in patients with low levels of these glycoproteins and depressed cellular immunity. The correlations between serum glycoprotein levels and in vitro and in vivo parameters of cellular immunity lend rationale to investigations of the interactions of serum glycoproteins and blood cells having immunologic function that determine the level of cellular immunity expressed in vivo.
先前研究表明，癌症患者血清中某些蛋白质水平会升高（急性期蛋白（APP）——触珠蛋白、α1 - 酸性糖蛋白、α1 - 抗胰蛋白酶）或降低（α2 - HS - 糖蛋白、前白蛋白、白蛋白）。本研究对147例术前可手术的实体恶性肿瘤患者进行了研究，这些患者的肿瘤局限于原发部位或仅发生区域扩散，分析了上述蛋白质水平与肿瘤范围、体外淋巴细胞对植物血凝素（PHA）的反应性（LR）以及对二硝基氯苯（DNCB）的定量迟发型超敏反应（DH）之间的相关性。与58名正常对照相比，局部或区域肿瘤患者的APP水平显著升高，α2 - HS - 糖蛋白和前白蛋白水平降低，白蛋白水平无变化。对DNCB迟发型超敏反应正常的患者，其APP水平高于对照组，前白蛋白水平低于对照组；对DNCB迟发型超敏反应受损的患者，其触珠蛋白和α1 - 酸性糖蛋白水平高于对DNCB迟发型超敏反应正常的患者，α2 - HS - 糖蛋白和前白蛋白水平低于后者。各组白蛋白水平与正常对照无差异。血清蛋白水平似乎与患者的免疫状态关系更大，而非肿瘤范围。三种APP水平彼此直接相关，但与α2 - HS - 糖蛋白和前白蛋白呈负相关；α2 - HS - 糖蛋白和前白蛋白水平彼此直接相关。触珠蛋白和α1 - 酸性糖蛋白水平与对PHA的LR呈负相关；然而，α2 - HS - 糖蛋白水平与对PHA的LR呈正相关，并且在癌症患者中测量的对DNCB的四种定量水平的迟发型超敏反应中，α2 - HS - 糖蛋白水平和对PHA的LR均呈现相似变化。数据表明，除白蛋白外，所研究的蛋白质与细胞免疫的体外和体内参数呈负相关（APP）或正相关（α2 - HS - 糖蛋白和前白蛋白）。这些结果为通过降低循环中APP水平来改善低下的细胞免疫提供了理论依据，目前正在进行的血浆置换试验就是如此，同时也为评估外源性α2 - HS - 糖蛋白或前白蛋白对这些糖蛋白水平低且细胞免疫低下患者的影响提供了理论依据。血清糖蛋白水平与细胞免疫的体外和体内参数之间的相关性为研究血清糖蛋白与具有免疫功能的血细胞之间的相互作用提供了理论依据，这些相互作用决定了体内表达的细胞免疫水平。
