악성환자에서 요중 Polyamine의 임상적 의의

Abstract

The polyamines are straight-chained amines essential for DNA stabilzaion and cell proliferation. They are present in all living cells, and their levels are generally increased in tumor cells. An intimate relation between polyamines and cellular grouth is evident from the existing literature, but the role of polyamines in carcinomatous growth has not been established and it remains a controversy whether polyamine analysis can be of any use as a marker for carcinoma. So, we checked urinary polyamine concentrations by polyamine test-enzyme kit(Tokuyama Co., Japan) in previously untreated, pathologically confirmed cancer patients; stomach cancer in 11, eso-phageal cancer in 4, hepatoma in 5, pancreas cancer in 2, lung cancer in 15, lymphoma in 4, leukemia in 2, and normal control in 24. The results were as follows; In the normal controls, mean urinary polyamine concentrations were not different between sexes (male 42.3±20.4μmol/g creatinine vs. female 51.8±16.1 μmol/g creatinine). The mean urinary polyamine concentrations were signficantly higher values in total(118.6±165.4μmol/g creatinine) and male(112.5±131.1 μmol/g creatinine) cancer patients than that of normal controls(45.5±19.3μmol/g creatinine) (P<0.005). In gastrointestinal cancer, the mean urinary polyamine concentrations were significantly higher values in total(126.6e±149.4μmol/g creatinine), male(148.5±170.2μmol/g creatinine)(p<0.005), stomach(100.5±114.4μmol/g creatinine) & pancreas cancer (364.4 ±356.6μmol/g creatinine) (p<0.05) than that of normal controls. In lung cancer, the mean urinary polyamine concentrations were significantly higher values in total(120.2±220.4μmol/g creatinine), male(71.1±36.2μmol/g creatinine), and non-small cell carcinoma(137.1±257.5μmol/ g creatinine) thean that of normal controls(p<0.05). In hematological cancers, the mean urinary polyamine concentrations were significantly higher values in female patients(142.4±73.2μmol/g creatinine)(p<0.05) only. The sensitibity, specificity, posiive predictive value, and negative predictive value of mean urinary polyamine concentrations were 47.7%, 79.2%, 79.2% 80.8%, and 45.2% respecively by upper normal value of mean plus one standard deviation, and 38.6%, 95.8%, 94.4%, 46.0% respectively by upper normal value of mean plus two standard deviation. These result suggest that the measurement of urinary polyamine concentrations were not specigic for a specific cancer,however as a useful tool for the detection of some malignancies.