Tomás C, Puistola U, Risteli L, Risteli J, Kauppila A
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Acta Obstet Gynecol Scand. 1993 Jul;72(5):391-5. doi: 10.3109/00016349309021120.
Serum concentration of PIIINP (aminoterminal propeptide of type III procollagen), an indicator of connective tissue metabolism, is often increased in advanced gynecological carcinoma and correlates with the tumor growth. Because the healing wound also affects collagen metabolism we measured the serum PIIINP concentration in 15 patients operated on for endometrial carcinoma and in 28 patients operated on for benign gynecological diseases. Serial serum samples were collected for 35-51 days after surgery. In endometrial carcinoma, serum PIIINP level was increased in 53% of the patients before the operation. Postoperatively, the mean PIIINP concentration increased further, remaining at a pathological level throughout the study and with a peak at one week after the operation. In relative terms an abdominal operation for benign disease increased the serum PIIINP concentration as much as in endometrial carcinoma, but the mean level remained within the reference interval. After vaginal operation the increase in PIIINP concentration was not significant. The initially increased PIIINP concentration in endometrial carcinoma is probably caused by the effects of the malignancy on collagen metabolism. Because the relative response of PIIINP to abdominal operation was similar in both groups, the PIIINP response to surgical trauma in patients with malignant disease seems to depend only on the extent of the operation. In this group the transient increase in serum PIIINP concentration does not prevent the use of PIIINP as a tumor marker, since the follow-up examinations for malignancy do not start earlier than two months after operation.
血清Ⅲ型前胶原氨基端前肽（PIIINP）浓度是结缔组织代谢的一项指标，在晚期妇科癌症中常升高，且与肿瘤生长相关。由于愈合伤口也会影响胶原代谢，我们检测了15例行子宫内膜癌手术患者及28例行良性妇科疾病手术患者的血清PIIINP浓度。术后35 - 51天收集系列血清样本。在子宫内膜癌患者中，53%的患者术前血清PIIINP水平升高。术后，平均PIIINP浓度进一步升高，在整个研究期间一直处于病理水平，且术后1周达到峰值。相对而言，良性疾病的腹部手术使血清PIIINP浓度升高的幅度与子宫内膜癌相同，但平均水平仍在参考区间内。阴道手术后PIIINP浓度升高不显著。子宫内膜癌患者最初升高的PIIINP浓度可能是由恶性肿瘤对胶原代谢的影响所致。由于两组中PIIINP对腹部手术的相对反应相似，恶性疾病患者中PIIINP对手术创伤的反应似乎仅取决于手术范围。在该组中，血清PIIINP浓度的短暂升高并不妨碍将PIIINP用作肿瘤标志物，因为恶性肿瘤的随访检查在术后两个月后才开始。
