Painbeni T, Gamelin E, Cailleux A, Le Bouil A, Boisdron-Celle M, Daver A, Larra F, Allain P
Laboratoire de Pharmacologie et Toxicologie, CHU Angers, France.
Eur J Cancer. 1997 Nov;33(13):2216-20. doi: 10.1016/s0959-8049(97)00318-3.
The concentration of total sialic acid (TSA) is increased in the plasma of patients with many types of cancer. The purpose of this study was to assess the usefulness of the TSA marker in predicting the efficacy of the treatment, and to compare TSA with two common markers, carcinoembryonic antigen (CEA) and the carbohydrate antigen 19-9 (CA 19-9). The study was performed on 44 patients treated for advanced colorectal carcinoma by a weekly 8 h continuous infusion of 5-fluorouracil (1300 mg/m2) plus bolus injection of L-folinic acid (100 mg/m2). TSA, CEA and CA 19-9 levels were measured before and after 3 months of treatment and their variations analysed as a function of the response to the treatment. TSA levels of patients with metastatic colorectal carcinoma before treatment (959 +/- 265 mg/l) were significantly higher than those of 32 healthy people (584 +/- 99 mg/l). The percentage of patients with TSA concentration above the cut-off level (782 mg/l) was 73% before treatment and 23% after. All patients who experienced an objective response to the treatment (complete, partial or minor response) (n = 29) had a significant decrease of TSA levels (t = 5.96; P < 0.001). When the disease was considered as stabilised (n = 10), TSA changed slightly, but it increased with progressive disease (4 out of 5 patients). Changes in CEA and CA 19-9 did not correlate as well as TSA to the treatment efficacy. Initial levels of TSA did not permit prediction of the efficacy of the treatment since they were not significantly different between the five response groups. TSA seems to be more likely involved in tumour changes than in tumour volume. Its determination could provide useful information about the spreading and metastatic properties of the tumour. TSA normalisation is an indicator of probable tumour growth arrest and its elevation could be a marker of relapse.
多种癌症患者血浆中的总唾液酸（TSA）浓度会升高。本研究的目的是评估TSA标志物在预测治疗疗效方面的实用性，并将TSA与两种常见标志物癌胚抗原（CEA）和糖类抗原19-9（CA 19-9）进行比较。该研究对44例接受晚期结直肠癌治疗的患者进行，治疗方法为每周8小时持续输注5-氟尿嘧啶（1300 mg/m²）加推注亚叶酸钙（100 mg/m²）。在治疗3个月前后测量TSA、CEA和CA 19-9水平，并根据治疗反应分析其变化。转移性结直肠癌患者治疗前的TSA水平（959±265 mg/l）显著高于32名健康人（584±99 mg/l）。TSA浓度高于临界值（782 mg/l）的患者百分比在治疗前为73%，治疗后为23%。所有对治疗有客观反应（完全缓解、部分缓解或轻微缓解）的患者（n = 29）TSA水平均显著下降（t = 5.96；P < 0.001）。当疾病被认为稳定时（n = 10），TSA变化轻微，但在疾病进展时升高（5例患者中有4例）。CEA和CA 19-9的变化与治疗疗效的相关性不如TSA。TSA的初始水平无法预测治疗疗效，因为五个反应组之间没有显著差异。TSA似乎更可能与肿瘤变化有关，而不是肿瘤体积。其测定可为肿瘤的扩散和转移特性提供有用信息。TSA正常化是肿瘤生长可能停滞的指标，其升高可能是复发的标志物。
