URINARY DIACETYLSPERMINE AS AN INDICATOR OF CONDITION OF PATIENTS WITH MALIGNANT DISEASES

二乙酰亚精胺（DiAcSpm）是人体尿液中的一种微量多胺成分。其在健康人体内的排泄量较低，但在癌症患者体内经常显著增加。在这项研究中，我们测量了DiAcSpm和其他肿瘤标志物在结直肠癌和乳腺癌患者。248例大肠癌患者术前血清DiAcSpm（正常范围：0 ~ 0.25μmol /g肌酐）和CEA（正常范围：0 ~ 5ng/ml）阳性率分别为76.5%和40%。随着肿瘤分期的进展，DiAcSpm和CEA的阳性率均有升高的趋势。DiAcSpm对早期结直肠癌特别敏感，0期和1期的阳性率分别为62%和60%。这些早期癌症的CEA阳性率仅为10%。尿DiAcSpm水平即使在肿瘤病变保持静止状态时也趋于低水平，而随着复发而迅速上升。DiAcSpm可作为结直肠癌复发的预后指标和标志物。83例乳腺癌患者尿DiAcSpm阳性率为60%，血清CEA阳性率为37%，血清CA15-3阳性率为37%（正常范围23U/ml）， DiAcSpm阳性率明显高于CLA和CA15-3。DiAcSpm检测I期和II期乳腺癌的敏感性也高于CEA和CA15-3。DiAcSpm可以作为一种通用的肿瘤标志物，因为任何癌症组织的活跃增殖都可能伴随着多胺代谢的激活。此外，检查尿液对人体是无创的。鉴于这些特点，DiAcSpm可能是一种有用的措施，以筛选癌症患者。

Diacetyispermine (DiAcSpm) is a minor polyamine component in the human urine. Its excretion is low in amount in healthy persons, but is frequently and markedly increased in cancer patients. In this study we measured DiAcSpm and other tumor markers in colorectal and breast cancer patients. The positive rates of DiAcSpm (normal range: 0-0.25μmole/g creatinine) and serum CEA (normal range: 0-5ng/ml) with 248 preoperative colorectal cancer patients were 76.5 and 40%, respectively. The positive rates of both DiAcSpm and CEA tended to increase with the progression of cancer staging. DiAcSpm was particularly sensitive for earlier stage colorectal cancer in that the positive rates for stage 0 and stage I cancer were 62 and 60%, respectively. The positive rates of CEA for these early stage cancers were only 10%. Urinary DiAcSpm level tended to remain low even in tumor-bearing individuals when their cancerous lesions remained static, while rose rapidly concomitant with recurrence. DiAcSpm may serve as a prognostic indicator and marker for recurrence of colorectal cancer. As to 83 breast cancer patients, the positive rates of urinary DiAcSpm, serum CEA and serum CA15-3 (normal range: 23U/ml) were 60%, 37% and 37%, respectively, the positive rate of DiAcSpm being significantly high as compared to CLA and CA15-3. DiAcSpm was also more sensitive in detecting stage I and II breast cancers than CEA and CA15-3. DiAcSpm may serve as a general tumor marker, since active proliferation of any cancer tissue would likely be accompanied by activation of polyamine metabolism. Moreover, examination of the urine is non-invasive to human body. In view of these characteristic features, DiAcSpm may be useful as a measure for screening cancer patients.