泌尿性器悪性腫瘍における血清および尿FDPの検討

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  • SERUM AND URINARY FIBRIN/FIBRINOGEN DEGRADATION PRODUCTS (FDP) IN PATIENTS WITH UROLOGIC MALIGNANCIES
  • ヒニョウ セイキ アクセイ シュヨウ ニ オケル ケッセイ オヨビ ニョウ F

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FDP of serum and urine specimens from 64 patients with urologic malignancies (bladder carcinoma, 33 cases; renal cell carcinoma, 12 cases; carcinoma of the renal pelvis, 3 cases; ureteral carcinoma, 1 case; prostatic carcinoma, 9 cases; prostatic sarcoma, 1 case; testicular embryonal carcinoma, 3 cases; penile carcinoma, 2 cases) have been assayed using a tanned-red cell haemagglutination inhibition technique. In addition, urinary FDP have been studied by immunoelectrophoresis.<br>The results obtained are as follows:<br>1. High levels of serum FDP were observed in 14 of the 64 patients (21.9%). Elevated serum FDP values were seen in 4 of 8 patients (50%) with distant metastasis and 8 of 52 patients (15.4%) without distant metastasis.<br>2. Urinary FDP level increased in 35 of the 64 patients (54.7%), and a highly significant increase of this level was observed in a group of patients with primary or secondary bladder carcinomas as compared with the control group. Urinary FDP level in patients with bladder carcinomas of high stages (Stages B2 and C) was considerably higher than that in patients with bladder carcinomas of low stages (Stages O, A and B1).<br>3. There was no significant relationship between serum and urinary FDP levels in the 64 patients.<br>4. Urinary FDP levels remarkably decreased after surgical intervention for tumors in 32 patients, while their serum FDP levels showed no significant change.<br>5. Using the immunoelectrophoretic assay system for identification of FDP fragments, all fragments X, Y and E except fragment D were consistently detected in each of urine specimens of 25 patients.<br>6. It may be postulated that a part of the urinary fragment E originates from fragment E in the circulating blood and the appearance of early FDP, fragments X and Y, in urine indicates the occurrence of local fibrinolysis in and around the cancerous tissues.<br>The clinical usefulness of FDP determinations, especially urinary one, for the diagnosis and follow-up study of urologic malignancies is stressed.

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