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前列腺癌中的血清蛋白。IV. 冷冻前列腺切除术后的变化及临床反应。

Serum proteins in prostatic cancer. IV. Alterations and clinical response following cryoprostatectomy.

作者信息

Ablin R J, Soanes W A, Gonder M J

出版信息

Urol Int. 1979;34(5):339-49. doi: 10.1159/000280279.

Abstract

Evaluation of alterations in the level of the five major electrophoretic fractions of serum proteins (albumin, alpha 1-, alpha 2-, beta- and gamma-globulin) in 18 patients with prostatic cancer prior to and following cryoprostatectomy disclosed: (i) a progressive increase in the level of alpha 2- and beta-globulin and the incidence of patients possessing statistically significant (p less than 0.05) elevations in these proteins with a progression of the stage of their malignancy; (ii) a significant decrease in albumin, alpha 2- and beta-globulin and increase in alpha 1- and gamma-globulin from their preoperative levels following cryoprostatectomy in patients with metastatic disease (stage III) in association with a favorable clinical response; (iii) an overall significant decrease in albumin and alpha 2-globulin and increase in alpha 1-globulin from their preoperative levels and (iv) a general association of decreases in albumin (83% of the patients) and alpha 2-globulin (92%) and gamma-globulin (75%) with a favorable clinical response following cryoprostatectomy. Limited to study of a small patient population, the present results confirm earlier studies suggestive of a prognostic potential for alpha 2-globulin, as applied to stage identification in prostatic cancer once the initial diagnosis has been made. Pending confirmation and evaluation of a larger patient population, the observed alterations in serum protein, while not pathognomonic for prostatic cancer, and alterations of inhibitory ('immunoregulatory') factors, may provide adjunctive criteria for monitoring the clinical response following cryoprostatectomy.

摘要

对18例前列腺癌患者在冷冻前列腺切除术前和术后血清蛋白的五个主要电泳组分(白蛋白、α1-、α2-、β-和γ-球蛋白)水平变化的评估显示:(i)α2-和β-球蛋白水平逐渐升高,且随着恶性肿瘤分期的进展,这些蛋白水平具有统计学显著升高(p<0.05)的患者比例增加;(ii)转移性疾病(III期)患者在冷冻前列腺切除术后,白蛋白、α2-和β-球蛋白水平较术前显著降低,α1-和γ-球蛋白水平升高,同时伴有良好的临床反应;(iii)白蛋白和α2-球蛋白水平总体较术前显著降低,α1-球蛋白水平升高;(iv)冷冻前列腺切除术后,白蛋白(83%的患者)、α2-球蛋白(92%)和γ-球蛋白(75%)水平降低与良好的临床反应总体相关。限于对一小部分患者群体的研究,目前的结果证实了早期研究,提示α2-球蛋白在前列腺癌分期识别中具有预后潜力,一旦做出初步诊断即可应用。在对更大患者群体进行确认和评估之前,观察到的血清蛋白变化虽然不是前列腺癌的特征性表现,以及抑制性(“免疫调节”)因子的变化,可能为监测冷冻前列腺切除术后的临床反应提供辅助标准。

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