腎細胞癌における血清 Basic Fetoprotein の臨床的意義

Abstract

The clinical significance of serum basic fetoprotein (BFP) in renal cell carcinoma was investigated in comparison with serum immunosuppressive acid protein (IAP). Investigated in this study were 46 patients with renal cell carcinoma, 31 males and 15 females ranging in age from 40 to 85 years (mean age: 56 years). According to Robson's system of staging, 10 cases (22%) had a stage I disease, 14 cases (30%) a stage II disease, and 18 (39%) a stage IV disease. The positivity rate for and levels of serum BFP were found higher as disease stage advanced, with 54% of the entire cases and 72% of stage IV cases being positive for serum BFP. On the other hand, 76% of 34 cases for whom assay of serum IAP was feasible and 79% of stage IV cases were positive for serum IAP, thus here again the positivity rate for and serum levels of the marker became increasingly higher with advancing disease stage. Simultaneous assay of serum BFP and IAP demonstrated that 85% of stage IV renal cell carcinoma cases were positive for at least one of the two markers. A study of changes in these tumor markers before and after curative resection of the tumor showed that BFP decreased below the preoperative level within 1 week postoperatively in 92% and even returned to normal in 75% of cases who were positive for the tumor markers preoperatively, while serum IAP reduced below the preoperative level in 82% and returned to normal in 27% of the cases preoperatively.