Serum ferritin as a guide to therapy in neuroblastoma.
Serum ferritin as a guide to therapy in neuroblastoma.
复制标题
血清铁蛋白作为神经母细胞瘤治疗的指南。
作者：
H. Hann;H. M. Levy;A. Evans
在某些癌症患者中观察到血清铁蛋白水平升高而组织铁储存没有相应的增加。癌细胞中铁蛋白合成的增加也有报道。为了观察在神经母细胞瘤患者中是否出现类似的现象，我们用人铁蛋白抗体反电泳法对58例神经母细胞瘤患儿血清铁蛋白水平进行了筛选。血清中铁蛋白水平升高，反电泳呈阳性（大于或等于400 ng/ml），与活动性疾病的存在密切相关（Fisher精确2 × 2检验p < 0.001）。一项对58例患者中34例血清铁蛋白水平的纵向研究显示，血清铁蛋白升高与活动性疾病有相同的关联；铁蛋白水平恢复到正常范围与缓解相一致。原发性神经母细胞瘤肿瘤细胞和来自神经母细胞瘤细胞系的细胞含有铁蛋白，其电泳特征与正常肝铁蛋白不同。培养的6个神经母细胞瘤细胞系的上清液也含有铁蛋白。这些发现提示患者血清中铁蛋白的增加来源于肿瘤。血清铁蛋白水平可作为疾病活动性的指标和指导治疗。
Elevated serum ferritin levels without a corresponding increase in tissue iron storage have been observed in patients with certain cancers. Increased synthesis of ferritin by cancer cells has also been reported. In order to see whether similar phenomena occurred in patients with neuroblastoma, we have screened serum ferritin levels in 58 children with neuroblastoma by counterelectrophoresis using antibody to human ferritin. Increased ferritin levels in serum, positive by counterelectrophoresis (greater than or equal to 400 ng/ml), correlated well with the presence of active disease (p less than 0.001 by Fisher's exact 2 X 2 test). A longitudinal study of serum ferritin levels in 34 of the 58 patients showed the same association of elevated serum ferritin with active disease; a return of ferritin levels to the normal ranges coincided with remission. Primary neuroblastoma tumors and cells from neuroblastoma cell lines contained ferritins with the electrophoretic characteristics different from normal liver ferritin. Supernatant fluids from six neuroblastoma cell lines grown in culture also contained ferritin. These findings suggest that the increased ferritin in the serum of patients is derived from the tumor. The serum ferritin level could be used as indicator of disease activity and as a guide to therapy.