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題 名 | 轉移性腎細胞癌的診斷與治療=Diagnosis and Treatment of Metastatic Renal Cell Carcinoma |
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作 者 | 劉明謙; 高芷華; 鄭安理; 蔡敦仁; | 書刊名 | 內科學誌 |
卷 期 | 10:4 1999.08[民88.08] |
頁 次 | 頁121-125 |
分類號 | 415.74 |
關鍵詞 | 腎細胞癌; 紅血球生成素; 白介素-Ⅱ; α-干擾素; Renal cell carcinoma; Erythropoietin; EPO; Interleukin-Ⅱ; IL-Ⅱ; Alpha-interferon; α-INF; |
語 文 | 中文(Chinese) |
中文摘要 | 對於轉移性腎細胞癌(metastatic renal cell carcinoma),目前並沒有令人很 滿意的治療方法,早期發現早期治療,仍是不變的原則。丙種麩氨酸轉酵素(gamma glutamyl transpeptidase, γ-GT)可以作為早期偵測的指標。對於轉移性腎細胞癌,以 白介素-II(interleukin-ΙΙ, IL-II)和α-干擾素(α-interferon, α-INF)合併使用來 治療,可以達到較佳的有效率,是當前較熱門的研究題目和治療模式。此外,腎細胞癌的 病人中,約少於5%的病人體內紅血球生成素(erythropoietin)會升高,而造成紅血球增多 症(erythrocytosis) 。最近的研究結果顯示,這些紅血球生成素會升高的病人,對白介 素-II和α-干擾素有較好的療效。Janik提出假說,認為紅血球生成素在功能上作為一種 腫瘤抗原,而α-干擾素可以向上調控(up-regulate)主要組織相容複合體(major histocompatibility complex,MHC)抗原的表現,讓紅血球生成素呈現在細胞表面的MHC 抗原,從而加強抗癌作用。Rubins首先報告了以紅血球生成素治療轉移性腎細胞癌的病例 ,並且獲得不錯的療效;其中真正的機轉仍不清楚,系列研究,仍在進行中。不過,這對 轉移性腎細胞癌的治療,露出一絲曙光。對於轉移性腎細胞癌的各種治療,成績仍然欠佳 ;多模式的療法(multi-modality),尤其是免疫療法合併化學治療,是未來一條比較可行 的路。 。 |
英文摘要 | Till now there has been no satisfactory treatment for metastatic renal cell carcinomas. Early detection and early treatment remain the golden rule. Gamma-glutamyl transpeptidase was documented to be a useful predictor for early detection of metastatic renal cell carcinomas. Better remission rate could be achieved by the combined use of interleukin -II(IL-II)and α- interferon(α-INF). Less than 5% of the patients with renal cell carcinomas have their erythropoietin level elevated, which accounts for the erythrocytosis observed. This subset of individuals showed good response to the combined use of IL-II and α-INF. It is also noteworthy that some patients with metastatic renal cell carcinoma were successfully treated with erythropoietin. However, further series of follow up and complete investigations are necessary. The policy of using multi-modality treatment including various combinations of chemotherapy with immunotherapy is a potential access to be devoted to in the future. (J Intern Med Taiwan 1999; 10:121-125) |
本系統中英文摘要資訊取自各篇刊載內容。