口腔領域悪性腫瘍患者における尿中ポリアミンの検討
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Clinical usefulness of tumor markers in various types of cancer has been reported. These tumor markers are tumor-mediated substances and not tumor-specific substances. Of these markers, polyamines are non-protein nitrogen compounds universally found in life, and are intimately associated with many aspects of cell growth. Since the first demonstration by Russell et al. in 1971 that urinary polyamines increased in patients with malignant tumor, the urinary polyamines have been applied widely as a tumor marker for determination of clinical diagnosis and effect of clinical treatment, and have received increased attention. However, studies on the urinary polyamines in oral cancer patients have rarely been seen. In this study, urinary polyamines levels in 50 patients with oral cancer were measured by enzymic assay in order to investigate their clinical usefulness. The cut-off level of urinary polyamines was established at 44.9μmol/g・creatinine. The following results were obtained : 1. The average urinary polyamines of the 50 patients with oral cancer was 63.7±45.9μmol/g・creatinine and the positive rate was 62.0%. In contrast, the average for control patients with benign oral disease was 31.1±19.0μmol/g・creatinine and the positive rate was 13.5%. Statistically significant difference was found. 2. In urinary polyamines levels, cancer of floor of mouth was at the highest level and cancer of upper jaw was the second highest in oral cancers. 3. In histological types of oral cancer, the average urinary polyamines of 39 patients with oral squamous cell carcinoma (S.C.C.) was 65.4±47.4μmol/g・creatinine and the positive rate was 61.5%. Although other histologic types were relatively rare, in adenocystic carcinoma and in mucoepidermoid carcinoma the average levels were lower than in S.C.C. but higher in malignant lymphoma than in S.C.C. 4. With progress of clinical stage, urinary polyamines level gradually increased both its average and positive rate. But no remarkable correlation was found between the polyamines level and severity of cervical lymphnode metastasis. 5. No significant difference was found between polyamines levels before treatment in good prognosis cases and those in poor prognosis cases. However, positive rate immediately after treatment in poor prognosis cases was significantly higher than in good prognosis cases. 6. On the basis of the foregoing findings, although urinary polyamines have a certain limitation as a tumor marker, its level reflects the severity of condition and it should therefore be a useful indicator for estimating progress, effect of treatment, and prognosis.
- 1993-02-25
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