著明な白血球増多症を呈した上顎癌患者の1症例とその動物実験系の樹立

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Leukocytosis associated with malignant disease is known as a paraneoplastic syndrome. In this paper, we report the clinical course of a patient with maxillary cancer associated with marked leukocytosis. We also report the results of our attempt to establish an animal model in which pathogenesis of leukocytosis was studied.<BR>A 52-year-old man with an epidermoid carcinoma of the left maxillary sinus (T3N2M0) was seen January 18, 1984. He manifested an increase in white blood cell count (29, 300/mm<SUP>3</SUP>) with no clinical evidence of infection. When the tumor was resected surgically, white blood cell count returned to normal two weeks after surgery.<BR>Recurrence of the tumor resulted in renewed leukocytosis. Furthermore, when he effectively received chemotherapy (VEMF therapy), leukocyte count decreased in parallel with an inhibition of tumor growth. Discontinuation of chemotherapy because of severe side effects renewed leukocytosis and at most serious time, leukocyte number went up to 172, 000/mm<SUP>3</SUP>. More than 90% of leukocytes were granulocytes. From this clinical cours, it is suggested that tumor is responsible for leukocytosis in this patient.<BR>In order to confirm this we implanted the patients tumor into athymic nude mice and succeeded in establishment of tumor-bearing nude mice. Tumor-bearing mice showed marked leukocytosis similar to that of the patient. Surgical excision of the tumor resulted in a dramatic reduction of leukocyte number. These results led us to presume that this tumor is a colony stimulating factor (CSF) producing tumor. We recently found that cancer cells isolated from the tumor release CSF into the culture medium, which supports our presumption. It is, therefore, proposed that nude mice bearing the patients tumor are a suitable model to study pathogenesis of leukocytosis associated with malignancy.

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