泌尿器悪性腫瘍の診断における尿 Basic fetoprotein (BFP) の意義

Abstract

Basic fetoprotein (BFP) was measured by enzyme immunoassay in the urine of healthy adults and patients with benign or malignant urological diseases. Urinary BFP level in 34 healthy donors was very low (2.75 +/- 2.27 ng/ml). Since the BFP-positive rate is under 5% in healthy donors and, considering diagnostic efficiency for urological malignancies, a urinary BFP-concentration of 15 ng/ml was used as the cut off value. Urinary BFP was positive in 17.0% of 106 patients with benign urological diseases, in 51.9% of 52 patients with bladder cancer, in 75.0% of 8 patients with renal pelvic or ureteral cancer, in 25.0% of 20 patients with prostate cancer, and in 19.0% of 21 patients with renal cell carcinoma. In 60 patients with urothelial carcinomas, urinary BFP was higher in invasive diseases (greater than pT1) than in superficial diseases (p less than 0.05). The BFP level in urine also increased with a higher histological grade. The positive rate of urinary BFP was 78.9% in patients with invasive diseases and 66.7% in patients with grade 3 diseases. In 44 patients with urothelial carcinomas who underwent urinary cytological examination the positive rate was improved from 38.6% (17/44) to 81.4% (37/44) when measurement of urinary BFP was added. BFP in urine was found to be useful as a tumor marker for urothelial carcinomas. In addition, it was demonstrated that combined examination of urinary cytology with urinary BFP was more efficient for diagnosis of urothelial carcinomas.