前立腺癌患者における骨代謝,燐代謝の検討 : パラクライン的影響とエンドクライン的影響について

Abstract

We examined whether paracrine factors produced by prostate cancer cells can modulate bone metabolism in proportion to the volume of cancer cells in bone metastasis. Endocrine factors produced by prostate cancer cells affect both phosphate and 1, 25-dihydroxyvitamin D metabolisms. Levels of urine pyridinoline (U-Pyr) excretion and serum carboxy-terminal propeptide of type 1 procollagen (P1CP) in patients with bone metastasis were significantly higher than those in patients without bone metastasis (P< 0.05). In patients with bone metastasis (n= 1 7), serum prostate-specific antigen (PSA) levels were significantly correlated with the levels of U-Pyr and urine deoxypyridinoline (U-dPyr) excretion, serum cross-linked carboxyterminal telopeptide of type 1 collagen (1CTP), and P1CP levels (p < 0.05). However, serum PSA levels were not correlated with U-Pyr, U-dPyr excretions, serum ICTP and P1CP levels in patients without bone metastasis. Therefore, prostate cancer cells appear to have some paracrine effects on bone cells. In controls (n=15), serum 1, 25dihydroxyvitamin D levels (1, 25-(OH)2D) were inversely correlated with serum phosphorus levels (P<0.01). In prostate cancer patients with bone metastasis, the ability to regulate the serum 1, 25(OH)2D levels in response to serum phosphorus levels is lost. These results suggest that endocrine factors produced by prostate cancer cells disturb the regulation of serum 1, 25-(OH)2D in response to serum phosphorus levels. (Acta Urol. Jpn. 43: 849-854, 1997)