乳癌患者におけるProlactin及びTSH

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In order to investigate plasma prolactin and thyroid-stimulating-hormone (TSH) concentration and pituitary reserve of these two hormones in patients with breast cancer, following examinations were carried out. Plasma prolactin concentration was measured before and 15, 30, 60, 90 minutes after the 500μg of thyrotropin-releasing-hormone (TRH) i.v. injection in 22 patients with breast cancer and 4 patients with benign breast disease. All patients did not take any hormonal therapy and any medication inducing prolactin secretion. Ten healthy females were also tested as controls. Plasma prolactin concentration was estimated by a double antibody radioimmunoassay (RIA) technique using hPRL RIA kit provided by NIAMDD. The basal prolactin concentration in patients with breast cancer was 18.6±2.1 ng/ml (Mean ± SEM), and it was slightly higher than the control group (14.7±2.2 ng/ml), but not statistically significant. In 6 out of 22 patients with breast cancer, high plasma prolactin concentrations more than 25 ng/ml were observed. The maximal plasma prolactin concentration following the TRH injection was obtained at 15-30 minutes after TRH in most patients with breast cancer. The maximal value was 87.4 ± 9.2 ng/ml, and it was near the upper limit of normal range of prolactin response, and not significantly higher than the maximal value in the control group (59.7 ±5.7 ng/ml). In 7 patients with breast cancer, the maximal prolactin values more than 100 ng/ml were obtained after TRH injection. There was no statistically significant difference between early breast cancer group (TNM : stage I & II, N=14) and advanced breast cancer group (TNM : stage III & IV, N=6) in both the plasma prolactin concentration and the pituitary prolactin reserve. Also there was no significant difference between premenopausal patients (N=8) and postmenepausal patients (N=12) in the plasma prolactin concentration and the pituitary prolactin reserve. We observed the puzzling phenomenon that both the basal plasma prolactin concentration and the pituitary prolactin reserve in patients after radical mastectomy (N=7) were greater than those in patients who had not undergone any operation (N=15). This difference between these two groups were not statistically significant, but the prolactin reserve in patients after radical mastectomy was significantly greater than in control group (p<0.01). The basal plasma prolactin value and the maximal value after TRH injection in 4 patients with benign breast disease were 44.2 ± 14.5 ng/ml and 116.0 ± 30.9 ng/ml respectively. Both of these values were significantly higher than those in the control group (p<0.01, p<0.05). In 2 patients with mastopathy, abnormally high plasma prolactin levels more than 50 ng/ml were obtained, and in one patient of these two, abnormally great prolactin reserve was observed (more than 200 ng/ml of plasma prolactin after TRH). Plasma TSH concentration was measured before and 15, 30, 60, 90 minutes after 500 μg of TRH i.v. injection in 19 patients with breast cancer and 12 healthy control subjects. Plasma TSH concentration was estimated by the double antibody radioimmunoassay technique using the commercial kit provided by Daiichi Radioisotope Labs. (Tokyo). The basal plasma TSH level and the maximal TSH level after the TRH injection were 3.5 ± 0.5μU/ml and 21.7 ± 3.3 μU/ml, respectively, in patients with breast cancer. Both of these values did not differ from those in the control group (basal plasma TSH level : 5.8 ± 0.6 μU/ml, maximal TSH level after TRH : 20.1 ± 1.3μU/ml). From these results, following possibilities were indicated. (1) Breast cancer is able to develop under the circumstances with normal plasma prolactin concentration. But in about one third patients,
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乳癌患者におけるProlactin及びTSH

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