[Serum protein fractions in patients with laryngeal cancer undergoing radiation therapy. Possibility as a prognostic...

The levels of 21 protein components of the sera of 45 patients with cancer of the larynx undergoing radiation therapy were determined by a single radial immunodiffusion method before and after radiation therapy. We examined the correlation between changes in serum protein fractions and the prognosis of the patients. The patients with cancer of the larynx were treated with external irradiation of 60Co gammer-rays. Total target doses were 60 Gy. The levels of the same protein components were also measured in 43 normal adult individuals as a control. All patients were observed for 5 years and 12 years following radiation therapy. In the pretreatment sera obtained from patients with cancer of the larynx, the concentrations of prealbumin (Prealb), antithrombin III (ATIII) and plasminogen (Pmg) were significantly lower than controls. However the concentrations of alpha 1-acid glycoprotein (alpha 1AG), alpha 1-antitrypsin (alpha 1AT), alpha 1-antichymotrypsin (alpha 1X), haptoglobin (Hp), fibrinogen (Fib) and hemopexin (Hx) were elevated. At the completion of radiation therapy, the alpha 1AG, alpha 1AT, alpha 1X, Hp, Fib and inter alpha trypsin inhibitor (I alpha I) were significantly elevated than those normal controls. In patients without recurrent cancer after radiation therapy, the alpha 1AT, ceruloplasmin (Cp), Fib, IgA and Hx levels measured before radiation therapy were significantly lower than those patients with recurrent cancer. In patients without recurrent cancer after radiation therapy, the alpha 1AT, Hp, Cp, IgG, and IgA levels measured after radiation therapy were reduced compared with those patients with recurrent cancer. In patients who had lived more than 5 years after radiation therapy, the alpha 1AT, Cp and Fib levels measured before radiation therapy reduced significantly compared with those who had died within 5 years. In those who had lived more than 5 years, the alpha 1AG, alpha 1AT, Hp, Fib, IgG, and IgA levels measured after radiation therapy were reduced significantly compared with those who died within 5 years. In cases of laryngeal cancer following a period of 5 to 12 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease. AT III, Prealb, alpha 1AG, albumin (Alb) and I alpha I before radiation therapy were positively correlated with survival, whereas Hx, Pmg, Cp, IgM, Cl inhibitor (ClInh), alpha 1AT and Fib showed negative correlations. After radiation therapy, transferrin (Tf), Cp, Prealb, AT III and I alpha I were found to be positively associated with survival, whereas IgA, IgM, Pmg, alpha 1X and alpha 1AG were negative factors. From the elevation levels of acute phase proteins (alpha 1AT, Cp) and Fib and immunoglobulins (IgA, IgM) in the serum and lower levels of Prealb and AT III before and after radiation therapy, we may predict a relatively poor prognosis in these patients of laryngeal cancer.