Relationship between the changes of endocrine systems and prognosis in patients with cancer

癌症患者内分泌系统变化与预后的关系

• 批准号: 13671321
• 负责人: RINO Yasushi
• 金额: $ 2.24万
• 依托单位: yokohama city university
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671321/
• 关键词: gastric cancer; growth hormone; paradoxical response; thyrotropin releasing hormone; TRH負荷テスト; 成長ホルモンの奇異反応; 担癌; 進行胃癌; 予後; 内分泌環境; 食道癌; 担癌生体; 全身状態

Background : Patients with gastric cancer have been noted to have an abnormal response to thyrotropin releasing hormone (TRH) of growth hormone (GH). The abnormal response is called GH paradoxical response (PR). We estimated the correlation between endocrine abnormalities and prognosis of the patients with gastric cancer. Methods : Subjects were 101 patients with gastric cancer, 40 Stage I, 8 Stage II, 26 Stage III, 27 Stage IV. Stage I patients consisted of 29 males and 11 females. Stage II patients consisted of 5 males and 4 females. Stage III patients consisted of 23 males and 3 females. Stage IV patients consisted of 17 males and 10 females. None of the patients had a history of endocrine diseases. Serum GH and serum TSH levels were measured by radioimmunoassay before and after a single shot of 500 micrograms of TRH. PR were evaluated all patients. Collu et al reported that PR is defined by an increase to at least twice the baseline levels and greater than 5ng/ml. Survival rates were compared between PR positive and negative groups. Results : PR was observed 10 out of 40 cases in Stage I, and 12 out of 27 cases in Stage IV. PR positive rate was not significantly higher in Stage IV than Stage I patients. Whereas there are two patterns of PR. One is a rapid response after TRH administration (rapid response type) and the other is a late response (late response type). Positive PR group had no significant poor prognosis. However, prognosis of gastric cancer patients was better in PR negative group and late response type of PR than rapid response type of PR positive group. There was significant difference that p-value was 0.0002. Conclusions: PR of GH may be a good prognostic indicator in gastric cancer patients.

背景：胃癌患者对生长激素（GH）中的促甲状腺激素释放激素（TRH）有异常反应。这种异常反应被称为GH矛盾反应（PR）。我们估计了内分泌异常与胃癌患者预后的相关性。方法：101例胃癌患者，ⅰ期40例，ⅱ期8例，ⅲ期26例，ⅳ期27例。ⅰ期患者男性29例，女性11例。II期患者男性5例，女性4例。III期患者男性23例，女性3例。IV期患者男性17例，女性10例。所有患者均无内分泌疾病史。用放射免疫法测定单次注射500微克TRH前后血清GH和TSH水平。对所有患者进行PR评估。Collu等人报道，PR的定义是至少增加到基线水平的两倍，并且大于5ng/ml。比较PR阳性组和阴性组的生存率。结果：40例I期患者中有10例出现PR， 27例IV期患者中有12例出现PR， IV期患者PR阳性率不显著高于I期患者。然而，PR有两种模式，一种是TRH给药后的快速反应（快速反应型），另一种是延迟反应型（晚反应型）。PR阳性组无明显不良预后。而PR阴性组和PR晚期反应型胃癌患者的预后优于PR阳性快速反应型胃癌患者。p值为0.0002，差异有统计学意义。结论：GH的PR值可能是胃癌患者预后的一个良好指标。