Onizuka K, Migita S, Yamada H, Uwada O, Umemura Y, Kuroki M, Tateyama H
Department of Radiology, Miyazaki Prefectural Hospital, Japan.
Nihon Igaku Hoshasen Gakkai Zasshi. 1994 Sep 25;54(10):1007-17.
The levels of 23 protein components of the sera of 84 patients with uterine cervical cancer undergoing radiotherapy were determined by a single radial immunodiffusion method, before radiation therapy, after whole pelvic irradiation, and after intracavitary irradiation using a remote after roading system (RALS). We examined the correlations between changes in serum protein fractions and the prognosis of the patients. The patients with uterine cervical cancer were treated with combined external irradiation of 60Co gamma-rays or 10 MV X-rays, and RALS therapy. The levels of the same protein components were also measured in 21 normal adult women as a control. All patients were observed between 4 years and 8 years after radiation therapy. In the pretreatment sera obtained from patients with uterine cervical cancer, the concentrations of prealbumin (Prealb), alpha 2HS glycoprotein (alpha 2 HS), alpha 2-plasmin inhibitor (alpha 2PI), transferrin (Tf), plasminogen (Pmg), albumin (Alb), IgM and hemopexin (Hx) were significantly lower than those normal controls. However the serum concentrations of: alpha 1-antichymotrypsin (alpha 1 X), haptoglobin (Hp), C9, fibrinogen (Fib), ceruloplasmin (Cp), alpha 1-acid glycoprotein (alpha 1AG), alpha 1-antitrypsin (alpha 1AT) and C4 were elevated. At the completion of whole pelvic irradiation and RALS therapy, the Hp, C4, and Fib levels were significantly lower than those before radiation therapy, whereas Prealb, alpha 2HS and alpha 2PI were elevated. In patients who had lived between 4 years and 8 years after radiation therapy, the Cp, alpha 1 AG, Hp and C9 levels measured before radiation therapy were reduced significantly, while Tf was elevated compared with patients who died within 4 years. In those who had lived more than 4 years, the alpha 1 AT, Hp, alpha 1X, Cp and C9 levels measured after whole pelvic irradiation were reduced significantly; while the C4 level was elevated. In cases of uterine cervical cancer followed for a period of 4 to 8 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease. Tf, Pmg, and alpha 1AT before radiation therapy were positively correlated with survival, whereas AT III, Cp, C1Inh, IgA, alpha 1 AG and C9 showed negative correlations. After whole pelvic irradiation,Pmg, C4 Prealb, Alb,alpha 2M and Hp were found to be positively associated with survival, whereas Tf, alpha 2PI, AT III, alpha 1 AT,C1Inh, C9 and IgA were negative factors.
采用单向辐射免疫扩散法，测定了84例接受放射治疗的子宫颈癌患者放疗前、全盆腔照射后以及使用遥控后装系统（RALS）进行腔内照射后的血清中23种蛋白质成分的水平。我们研究了血清蛋白组分变化与患者预后之间的相关性。子宫颈癌患者接受了60Coγ射线或10MV X射线的体外联合照射以及RALS治疗。还测定了21名正常成年女性的相同蛋白质成分水平作为对照。所有患者在放疗后4年至8年期间进行观察。在子宫颈癌患者放疗前的血清中，前白蛋白（Prealb）、α2HS糖蛋白（α2HS）、α2 - 纤溶酶抑制剂（α2PI）、转铁蛋白（Tf）、纤溶酶原（Pmg）、白蛋白（Alb）、IgM和血红素结合蛋白（Hx）的浓度显著低于正常对照组。然而，α1 - 抗糜蛋白酶（α1X）、触珠蛋白（Hp）、C9、纤维蛋白原（Fib）、铜蓝蛋白（Cp）、α1 - 酸性糖蛋白（α1AG）、α1 - 抗胰蛋白酶（α1AT）和C4的血清浓度升高。在全盆腔照射和RALS治疗结束时，Hp、C4和Fib水平显著低于放疗前，而Prealb、α2HS和α2PI升高。在放疗后存活4年至8年的患者中，放疗前测定的Cp、α1AG、Hp和C9水平显著降低，而与4年内死亡的患者相比，Tf升高。在存活超过4年的患者中，全盆腔照射后测定的α1AT、Hp、α1X、Cp和C9水平显著降低；而C4水平升高。在子宫颈癌放疗后随访4至8年的病例中，采用多元回归分析来确定血清蛋白组分浓度升高是否与原发病的良好预后相关。放疗前Tf、Pmg和α1AT与生存呈正相关，而抗凝血酶III（AT III）、Cp、C1酯酶抑制剂（C1Inh）、IgA、α1AG和C9呈负相关。全盆腔照射后，发现Pmg、C4、Prealb、Alb、α2巨球蛋白（α2M）和Hp与生存呈正相关，而Tf、α2PI、AT III、α1AT、C1Inh、C9和IgA是负性因素。
