雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 39, Issue 10 （October 1987）

Brain and Nerve 脳と神経 39巻10号（1987年10月発行）

Japanese English

原著

頭蓋内腫瘍におけるβ₂—microglobulinの臨床的意義—Carcinoembryonic antigenとのcombination assayも含めて CLINICAL SIGNIFICANCE OF β₂-MICROGLOBULIN AND CARCINOEMBRYONIC ANTIGEN IN INTRACRANIAL TUMORS 鈴木康夫 ¹ , 石井鐐二 ¹ , 大塚良一 ¹ , 小川洋介 ¹ , 菊岡政久 ¹ , 平野一宏 ¹ , 田中隆一 ² Yasuo Suzuki ¹ , Ryoji Ishii ¹ , Ryoichi Otsuka ¹ , Yosuke Ogawa ¹ , Masahisa Kikuoka ¹ , Kazuhiro Hirano ¹ , Ryuichi Tanaka ² ¹川崎医科大学脳神経外科 ²新潟大学脳研究所脳神経外科 ¹Department of Neurosurgery, Kawasaki Medical School ²Department of Neurosurgery, Brain Research Institute, Niigata University pp.965-970

発行日 1987年10月1日 Published Date 1987/10/1

DOI https://doi.org/10.11477/mf.1406205992

PDF(3903KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　抄録　各種の腫瘍マーカーが臨床応用されているが，頭蓋内腫瘍に関しては未だ充分とはいえないのが現状である。今回，β₂—microglobulin （β₂—MG）が有用な脳腫瘍マーカーとなりうるか否かについてcarcino—embryonic antigen （CEA）とのcombination assayも併せて行い検討した。対象は，神経膠腫の血清34例（髄液15例），非神経膠腫18（7），惡性リンパ腫18（18），転移性脳腫瘍31（24）である。β₂—MGの血清の陽性率は低く，各群間で明らかな差は認められなかったが，髄液では悪性リンパ腫と転移性脳腫瘍で陽性率がそれぞれ83.3％，25.0％と高かった。一方，同時に測定したCEAは血清，髄液とも転移性脳腫瘍では陽性率がそれぞれ54.8％，33.3％であったが，悪性リンパ腫など他の3群では大多数が正常値を示した。以上より，頭蓋内腫瘍患者のβ₂—MG測定は，血清では脳腫瘍マーカーとしての有用性には限界があるが，髄液では悪性リンパ腫および転移性脳腫瘍で有意に高く，両者の有力な補助診断法になりうると考えられた。さらにCEAを同時に測定することにより，これら両者の鑑別も可能であることが強く示唆された。

β₂- microglobulin (β₂-MG) levels were deter-mined in serum, cerebrospinal fluid (CSF), and tumor cyst fluid obtained from patients with a variety of intracranial tumors. In addition, a simultaneous determination of the carcinoembryonic antigen (CEA) was carried out in some patients.

The β₂-MG levels were elevated in 11/101 in-tracranial tumors, including glioma (4/34), non-glial tumors (1/18), malignant lymphoma (2/18), and metastatic brain tumors (4/31). There were no significant differences in the β₂-MG levels of serum among the different patient groups. On the other hand, the β₂-MG levels in CSF were signifi-cantly higher in patients with malignant lymphoma and metastatic brain tumors than in those with glioma and non-glial tumors. Fifteen (83.3%) of 18 patients with malignant lymphoma and 6(25.0%) of 24 patients with metastatic brain tumors showed increased the levels of β₂-MG in CSF. The β₂-MG levels in the tumor cyst fluid of 11 intracranial tumors exceeded normal serum levels in all but two patients.

When the CEA levels in the serum and CSF were measured simultaneously, meaningful differ-ences between malignant lymphoma and metastatic brain tumors were clearly observed. The highest incidence and highest levels of the CEA in serum and CSF were only noted in patients with meta-static brain tumors. Conversely, the serum CEA was slightly raised in 11.8% of malignant lym-phoma and the levels of CEA in CSF were within normal range in all these patients. Serial deter-mination of CSF β₂-MG in patients with malignant lymphoma correlated well with their clinical findings.

Consequently, the β₂-MG in CSF may be a useful tumor marker in patients with malignant lymphoma and matastatic brain tumors. Simultaneous deter-mination of CEA is valuable for the differential diagnosis between these two groups.