Becciolini A, Porciani S, Lanini A
Department of Clinical Physiopathology, University of Firenze, Italy.
Int J Biol Markers. 1994;9(1):38-42. doi: 10.1177/172460089400900108.
This paper reports the results of studies on the possible role of biochemical markers in monitoring the effects of ionizing radiations and in the follow-up of cancer patients submitted to radiotherapy. Three different case series were analyzed: patients with head and neck cancer, prostate carcinoma and residual thyroid tumors or uptaking metastases (131-Iodine therapy). Serum TPA and amylase were serially determined in patients with head and neck or thyroid cancer to measure the radiation damage to the salivary glands. In the former group a statistically significant correlation between the increase of both molecules and the total dose administered after the first day of treatment (2, 3, 4 or 6 Gy) was observed. In patients treated for thyroid cancer the damage to the salivary glands was revealed by an increase in TPA and amylase serum levels, dependent on the dose of 131-Iodine administered. Moreover, an association was demonstrated between pretreatment values of TPA in patients with head and neck tumors and prognosis: patients with values below the cutoff have significantly higher survival rates than those with higher values. In patients with prostate carcinoma PSA was confirmed to have better diagnostic and prognostic value than PAP. Patients with metastases show an inversion or lack of negative trend in PSA levels observed in the disease-free patients. This precedes the clinical diagnosis of metastases by 1 to 15 months.
本文报道了关于生化标志物在监测电离辐射效应以及对接受放射治疗的癌症患者进行随访中可能发挥的作用的研究结果。分析了三个不同的病例系列：头颈癌、前列腺癌以及残余甲状腺肿瘤或摄取转移灶（碘 - 131治疗）的患者。对头颈癌或甲状腺癌患者连续测定血清组织多肽抗原（TPA）和淀粉酶，以测量唾液腺的辐射损伤。在前一组中，观察到治疗第一天后（2、3、4或6戈瑞）这两种分子的增加与总剂量之间存在统计学上的显著相关性。在接受甲状腺癌治疗的患者中，唾液腺损伤通过TPA和淀粉酶血清水平的升高得以体现，这取决于所给予的碘 - 131剂量。此外，头颈肿瘤患者治疗前TPA值与预后之间存在关联：低于临界值的患者生存率显著高于高于临界值的患者。在前列腺癌患者中，前列腺特异性抗原（PSA）被证实比前列腺酸性磷酸酶（PAP）具有更好的诊断和预后价值。有转移的患者PSA水平出现反转或缺乏无病患者中观察到的下降趋势。这比转移的临床诊断提前1至15个月。
