çãé µçŽ ããã¿ãã³B17
çãšã¯äœãïŒ
ã¹ã¿ã³ããŒããªçŸä»£å»åŠã§ã¯ããæ£åžžãªçްèãéºäŒåã®çªç¶å€ç°ã«ãããç¡ç§©åºã«å¢æ®ãç¶ããç
æ°(æªæ§è
«ç)ããšãã£ã説æã«ãªãã
倧äœã«ãããŠåã¯ããéºäŒããšããéºäŒåããæã¡åºããŠãã説æã¯å¥œãã§ã¯ãããŸããããªããªããããããèšããããšé»ããããåŸãªããããã§ãããéºäŒåã®å€ç°ãããããªã仿¹ãªãããšãªã£ãŠãå»è
ã«å§ããããããŸãŸã«ãæçå€ãšãæè¡ãšãæŸå°ç·ãªã©ã®æ²»çã¬ãŒã³ã«ä¹ããããªãã
åã¯ãé£äºæ¹åãšãçæŽ»ç¿æ
£ã®æ¹åãšããæ£è
ã«åªåã®äœå°ããã説æã奜ã¿ãŸããã ã£ãŠããã£ã¡ã®ã»ããåžæãæãŠããããªãã§ããã
ããšãã°100幎ã»ã©åããçã¯ããããã©ã¹ãã§ããããšèª¬æããç§åŠè ãããŸããã

粟åãšåµåãçµåãããšå粟åµã«ãªããããã现èåè£ãç¹°ãè¿ãããã®ããã«ããŠã§ããå€åŽã®çްèå±€ã®äžçŸ€ã¯ãåŸã«èç€ã«ãªãã®ã§ããããã®éšåãç¹ã«ããããã©ã¹ã(æ é€è现è)ãšåŒã³ãŸãã
çºçåŠãç ç©¶ããŠãããžã§ã³ã»ãã¢ãŒãã¯ããã®ããããã©ã¹ãããç
ççµç¹äžãç现èãšãã£ããåãã§ããããšã«æ°ã¥ããŸãããé¡åŸ®é¡ã§ã¯èŠåããã€ããªãããåãããã£ããã§ãããããšãã°ãããããã©ã¹ãã¯åå®®å£ã«é£ã蟌ã¿ã浞最ã墿®ãããçãšåãã§ããçåºã§ããå Žæã§ããã°ç¹ã«å Žæãåããªãç¹ããçã®è»¢ç§»èœãšäŒŒãŠãããã€ãŸããããããã©ã¹ãã¯ã浞最èœã墿®èœã転移èœãªã©ãçã®å€å
žçæ§è³ªããã¹ãŠåããŠããŸãã
ãŸããããããã©ã¹ãã¯hCG(ããçµšæ¯æ§ãŽãããããã³)ãç£çããŸããããã¯éèŠãªãã«ã¢ã³ã§ãå
ç«æå¶äœçš(æ¯äœãèå
ãæçµ¶ããªããã)ãè¡ç®¡æ°çä¿é²ãã¢ãããŒã·ã¹æå¶ãçŽ°èæµžæœ€èœäº¢é²ãšããäœçšããã£ãŠãåŠåš æç«ã®ããã«å¿
é ã§ãã
ãããŠé©ãã¹ãããšã«ãçãhCGãç£çããŸããããšãã°ãåŠåš ã®å¯èœæ§ã®ãªã人ã®å°¿æ€æ»ãããŠãå°¿äžhCGéœæ§ãªãããŸãééããªãçã§ã(æåºŠ92ïŒ
)ã
ã€ãŸããhCGã¯ãåã°ããåŠåš ããŒã«ãŒ(ãããã§ãã§ããã)ã§ãããšåæã«ãæ²åã®çããŒã«ãŒ(ãæ®å¿µãªããçã§ãã)ã§ããããšããããšã§ãã
ãã¡ãããäž¡è
ã¯ãŸã£ããåãã§ã¯ãããŸãããããããã©ã¹ãã«ã¯ãååã®æ¹åæ§ããããŸããèç€ãã§ãããžãã®ç·ãã§ãããšããå
·åã«ãæ§ã
ãªåšå®ã«ååããŠããååèœããããŸãããçã¯ã²ããã墿®ã浞最ã転移ãç¶ãããã€ãŸããååèœããªãããã®éãã¯ãããŸãããéã«èšããšãããã ãã®éãã§ãã
åŸã®ç ç©¶ã§ããããªçããŒã«ãŒãçºèŠãããŸããããçã®ååã®çšåºŠã«æ³šç®ããŠæŽçãããšã系統çã«ææ¡ã§ããŸãã

çããŒã«ãŒãšããã°ããCAãªããšããã¿ãããªã€ã¡ãŒãžããããŸãããããCAãªããšããã¯ãããããã®èåšã«çºçŸããç¹åŸŽçãªããŒã«ãŒã§ãçãšããŠã®åå床ã¯ãã£ããé«ãçã ãšãããŸãã
AFP(ã¢ã«ãã¡èå
ã¿ã³ãã¯)ãšãCEA(çèå
æå)ãªããã¯ããã®åå(èå
ãªããšã)ã瀺ãããã«ãCAç³»ããã¯åå床ãäœãããŒã«ãŒã§ãã
èå
ããããã£ãšå
ç¥è¿ãããŠãæãæªååãªçã«ãªããšãhCGãé«ããªããŸããäžè¬ã«ãæªååãªçã»ã©äºåŸäžè¯ã ããhCGã®è¡äžæ¿åºŠãé«ãã»ã©ãçã®æªæ§åºŠãé«ãããšãç¥ãããŠããŸãã
å粟åµ(èå
)ãèªèº«ãå®ãããã®æ©æ§ãšãçã®çåæŠç¥ãäžèŽããŠããã
ãã¢ãŒãã®ãã®çºèŠã¯ãçã®äœããããç¥ãããã§ã極ããŠç»æçã§ãããããã«åœŒã¯ãããèããŸããããèå
ãããããã©ã¹ãã®æé·ãå¶åŸ¡ããæ¹æ³ãçºèŠã§ããã°ããããçã®æ²»çã«å¿çšã§ããã®ã§ã¯ãªããã

çåºããããããã©ã¹ããã©ã®ããã«æµžæœ€ã墿®ããŠããã®ãããŸããã©ã®ã¿ã€ãã³ã°ã§ååããŠãèç€ãè垯ã«å€åããŠããã®ãã詳现ã«ç ç©¶ããçµæã圌ã¯ãèçºçãã56æ¥ç®ãã¡ããã©èå
ã®èµèãé
µçŽ ãåæ³ãå§ããã¿ã€ãã³ã°ã§ãååèœãå€åããããšãçªãæ¢ããŸããã
åå®®å£ã«é£ã蟌ã¿ã墿®ãç¹°ãè¿ããè¡ç®¡ã匵ãå·¡ãããŠããŸãã§çãã®ãã®ã®ããã«æ¯ãèã£ãŠããããããã©ã¹ãããèµèé
µçŽ ã«è§Šãããããªããååãå§ãããæªååãªçްèãèç€ã圢æããããã«ãªãããžãã®ç·ãäœãããã«ãªã£ãããèµé
µçŽ ãããæªååããæçã®å€åãä¿ãã·ã°ãã«ã§ã¯ãªããã
圌ã¯ãã£ããããŠã¹ã§å®éšããŸãããè
«çãç§»æ€ããããŠã¹ã«ããªãã·ã³(èµé
µçŽ )ãæ³šå
¥ãããšãèŠäºã«è
«çãçž®å°ãããèµé
µçŽ ãhCGã®ã·ã°ãã«(å
ç«æå¶ãè¡ç®¡æ°çãã¢ãããŒã·ã¹æå¶)ãæã¡æ¶ããæ£åžžçŽ°èãžã®ååãä¿é²ããã®ã ãšåœŒã¯èããŸããã
ãã®èª¬ãåŒãç¶ãã ã®ãããã¿ãã³B17ã®çºèŠè
ãã¢ãŒãã¹ãã»ã¯ã¬ãã¹ã§ãã圌ã¯ãã¢ãŒãã®èª¬ãçãšã¯å Žéããªã¿ã€ãã³ã°ã§çããããããã©ã¹ãã§ããããèµé
µçŽ ãç现èã®ååãä¿é²ããããå
šé¢çã«èªããããããããã«ã圌ç¬èªã®çè«ãæ§ç¯ããŸããã
ã¯ã¬ãã¹ã®æã倧èãªèª¬ã¯ãããã§ãã
ãçã¯ãã¿ãã³B17æ¬ ä¹çã§ããã


å€§èªæµ·æä»£ãå€ãã®è¹ä¹ãã®åœã奪ã£ãå£è¡ç ã¯ãææ©é¡ã®æåã«ããæ ¹çµ¶ãããŸãããå£è¡ç ã¯ãã¿ãã³Cæ¬ ä¹çã ã£ããšããããšã§ãã

æ¥é²æŠäºã§æ¥æ¬å µã®åœãäžçªå¥ªã£ãã®ã¯ããã·ã¢è»ã®éç«åšã§ã¯ãããŸãããèæ°ã§ããåœæèæ°ã¯ææçã ãšèããããŸããããç±³ã¬ãã®è£çµŠã§äžç¬ã®ãã¡ã«è§£æ¶ãããŸãããèæ°ã¯ãã¿ãã³B1æ¬ ä¹çã ã£ããšããããšã§ãã
åæ§ã«ãã¯ã¬ãã¹ã¯ãçã¯ãã¿ãã³B17æ¬ ä¹çã ãšèããŸãããå®éãçæ£è
ã«ãã¿ãã³B17ãæäžããããšã§ãåœŒã¯æ°å€ãã®çæ£è
ãæ²»çãããŸãããããã«ãã»ãããŒããžã§ã³ã»ãªãã£ãŒããœã³ãªã©ãã¯ã¬ãã¹ã®çè«ãæ¡çšããŠãçæ£è
ã®æ²»çã«ææããããå»åž«ã¯ä»ã«ã倿°ããŸãã
ãªãããã¿ãã³B17(ã¢ãã°ããªã³)ãçã«å¹ãã®ãããã®çè«ã«ã€ããŠããã¯ã¬ãã¹ã¯è§£ãæãããŠããŸãã
以äžããã¿ãã³B17ãšã¢ãã°ããªã³ã¯åããšæã£ãŠããã ããŠãã£ããã§ãããã¿ãã³Cãã¢ã¹ã³ã«ãã³é
žããã¿ãã³B1ããã¢ãã³ãšåŒã¶ã®ãšåããããªãã®ã§ãã

ã¢ãã°ããªã³ã¯ãäœå
ã§Î²ã°ã«ã³ã·ããŒãŒãšããé
µçŽ ã«ããåè§£ãããã°ã«ã³ãŒã¹ããã³ãºã¢ã«ããããã·ã¢ã³åç©ãçããŸãããã³ãºã¢ã«ããããã·ã¢ã³ã詊éšç®¡å
ã§ããããæçäœçšããããŸãããäž¡è
ã®äœµçšã§å¹æãçžä¹çã«é«ãŸããåç¬æäžã®ãã£ãš100åã®æçäœçšããããŸãã
ããã§å
åãããŠèšã£ãŠãããŸããããã¬ããå»åž«äŒãå
¬çæ©é¢ã¯ããã¯ã®çš®ã¯ã·ã¢ã³ãå«ãããå±éºïŒçµ¶å¯Ÿé£ã¹ããªïŒããªã©ãšå§äŒããŠããŸãã

ããã¯ãã¡ããåã§ããäºå®ã¯ããã¯çš®ã»ã©äœã«ãããã®ã¯ãªããã§ãã

é·å¯¿ã§æåãªãã³ã¶å°æ¹ã®äœæ°ã¯ããããã®çš®ã倧æããåžžé£ããŠããŸãããã·ã¢ã³ããããªã«å±éºãªãã®ãªãã圌ãã¯é·å¯¿ã©ãããããšã£ãã®æã«çµ¶æ» ããŠããã¯ãã§ãã

ã·ã¢ã³ããããªã«å±éºãšãããªãã°ããã¿ãã³B12ãªããŠçæ¯ãšããããšã«ãªããã©ã圌ãã¯ããããççŸã«ã¯æ²é»ããŸãã
ãªãã¢ãã°ããªã³ãçã«å¹ãã®ãã説æã®ç¶ãã§ãã

ã¢ãã°ããªã³ãæåããŠããããç现èã«åã蟌ãŸãããšãç现èã«ã¯Î²ã°ã«ã³ã·ããŒãŒã髿¿åºŠã«å«ãŸããŠããŠãã·ã¢ã³ã倧éã«çºçããŸããããã«ãããç现èã¯å€§ææãåããã¢ãããŒã·ã¹(çŽ°èæ»)ã«è³ããŸãã
βã°ã«ã³ã·ããŒãŒã¯å£è
å
ãè
žäžç®ãèèãªã©ã«ãããã®ã§ãããã§ã·ã¢ã³ãçºçãããããæ£åžžçŽ°èã«åã蟌ãŸããŸãããæ£åžžçŽ°èã«ã¯ããããŒãŒãšããé
µçŽ ã髿¿åºŠã«å«ãŸããŠããŸããããããŒãŒã¯ã·ã¢ã³åè§£é
µçŽ ã§ãã·ã¢ã³ããã¿ããã«ç¡å®³ãªããªã·ã¢ã³ã«å€æããŸãã
èªç¶ã®åŠãšããã¹ãããç现èã«ã¯ããããŒãŒ(ã·ã¢ã³åè§£é
µçŽ )ãã»ãšãã©å«ãŸããŠããããβã°ã«ã³ã·ããŒãŒã倧éã«å«ãŸããŠãããããã·ã¢ã³ã®æ¯æ§ãã¢ãã«åããŸããäžæ¹ãæ£åžžçްèã«ã¯Î²ã°ã«ã³ã·ããŒãŒãã»ãšãã©å«ãŸããŠããªããããæ£åžžçŽ°èã®å
éšã§ã·ã¢ã³ãçºçããããšã¯ã»ãŒãããŸããã
ãã®ãæ£åžžçްèå
ã«ãããããããŒãŒ ïŒÎ²ã°ã«ã³ã·ããŒãŒãç现èå
ã«ãããβã°ã«ã³ã·ããŒãŒ ïŒããããŒãŒã®é
µçŽ é
åããããã¢ãã°ããªã³ã®çéžææ¯æ§ã®ãã¢ãšãªãéšåã§ãã
ãããããã»ã©ãã·ã¢ã³ãæ£åžžçްèã«åã蟌ãŸãããšãããããŒãŒã«ãã£ãŠç¡å®³ãªããªã·ã¢ã³ã«å€æããããšèšããŸããããæ¬åœã®ããšããããšãããªã·ã¢ã³ã¯ãç¡å®³ã©ããããããèªäœãæçäœçšã®ãããããããç©è³ªã§ãã

ããªã·ã¢ã³ãå€ãå«ã飿ã¯ããã®ãŸãŸã€ã³ãŒã«ãæçäœçšã®ãã飿ãšèããŠããããããã§ããããšãã°ãã¢ãã©ãç§æ€ç©(ãã£ããããããã³ãªãŒãã«ãªãã©ã¯ãŒãã¯ãµããã¢ãã©ããªã©)ãããã€ã€ã®çš®ãªã©ãç©æ¥µçã«é£ã¹ãã°çäºé²ã«ããã§ããã
ãšãããããã埮éã®ã·ã¢ã³æ¯ãªããäžæã«æŽ»çšã§ããã®ã人äœã®ãã°ãããã§ãã

å
ã»ã©èšã£ãããã«ãβã°ã«ã³ã·ããŒãŒã¯ç现è以å€ã«ããå£è
ãæ¶å管ãèèãªã©ã«ããã£ãŠãå£è
ã§ã·ã¢ã³ãçããã°ãæèäœçšã«ãããè«æ¯äºé²ã颚éªäºé²ã«ããªããè
žã§çããã°ãéœåãããããšã«ãæªçèã ããæ®ºããŠãããŠãè åéåæŽ»çºåã飿¬²å¢é²äœçšããããè¡äžã§ã·ã¢ã³ãçããã°ãé è¡ãä¿é²ãããè¡å§ã®èª¿æŽäœçšãããã
çæ£è
ã§ã¯ã飿¬²äœäžãè²§è¡ãèŠããããã®ã ãã©ãããããç¹ã§ããã¢ãã°ããªã³ã¯å¥œãŸãã圱é¿ãäžãããšããããšã§ãã

ã¢ãã°ããªã³ãβã°ã«ã³ã·ããŒãŒã«ããåè§£ããããšãã·ã¢ã³ä»¥å€ã«ããã³ãºã¢ã«ããããçºçããŸãããã®ãã³ãºã¢ã«ãããã¯ã代è¬ãããŠã宿¯éŠé žã«ãªããŸãã宿¯éŠé žã«ã¯é®çäœçšãããã®ã§ãé çæã¡ã®äººã¯ãããœãã³ãããªããŠããããã®çš®ã1åã§ãé£ã¹ãã°ããããã®ã»ããããã»ã©ç¡å®³ãªé®çè¬ã«ãªããŸããçã®æ«ææ£è ã¯çã¿ã«èŠãããã®ã ããããã®ç¹ã§ãã¢ãã°ããªã³ã¯åªããŠããã
ãã£ãšãã·ã¢ã³ãå€ãå«ã飿ãæããŠã¿ãã

ãã£ããµãããåç¥ã§ãããæ±åã¢ãžã¢ã®åäœæ°ã¯ãäœåäžå¹Žãšãã倪å€ã®æããããã£ããµããäž»é£ãšããŠé£ã¹ãŠããŸãããã·ã¢ã³ãæ¯ç©ãªãããã¯ãããšã£ãã®æã«ãã®å°åã®äººãã¡ã¯çµ¶æ»
ããŠããã¯ãã§ãã
ã¡ãªã¿ã«ãäžææå€§ããŒã ã«ãªã£ãã¿ããªã«ã¯ãã£ããµããåæãšããŠäœãããŸããç ç³ã倧éã«å«ãŸããŠãããããå§ãã¯ããŸãããã
ãããªã©ã®éç©ããã°ã«ãã·ã¢ã³ãå«ãŸããŠããããšãç¥ã人ã¯ããŸãããŸããã
ãããŠããªããšãã£ãŠãããã©ç§æ€ç©ã®çš®ã§ãããæ¢
ããã¯ãæããããããŒãæ¡ãããããã¢ãŒã¢ã³ãããã«ãŒã³ãã€ããŽãªã©ããããŸããæ¢
ã®çš®ãæ¡ã®çš®ãªããŠãåºãããã©ããšããã¡ã§å²ã£ãŠé£ã¹ãã°ããããã¯ã®çš®ããããã®çš®ãã¢ãŒã¢ã³ãã¯é£ã¹ãããã

ãã¿ãã³B17ã¯æ°Žæº¶æ§ã§ãäœå ã§ä»£è¬ããããš2ã3æéã§æåºãããŸããæ°Žæº¶æ§ãã¿ãã³ãªã®ã§éå°çã®å¿é ã¯ãªããããããçãæ²»ãç®çã§é£ã¹ãã®ãªãã2ïŒ3æéã®ããã«ããããé£ã¹ãæèŠã§ããã¯çš®ãé£ã¹ããšããã
ããšãã°ããããã§æŸã£ãç»åã

çãšèšºæãããããããããæšæºæ²»çãå«ã§ããã¿ãã³B17çæ³ãããããšã«ããããããã®çš®ã1æ¥40åé£ã¹ããšãããçãæ²»ã£ãŠããŸã£ãããšãã話ã
æ°ãæåã«äžèšã®ãã¢ãŒããã¯ã¬ãã¹ã®ä»äºãç¥ã£ãŠä»¥åŸãåœé¢ã§ãçæ£è
ã«é
µçŽ ã®ç©æ¥µçæçšãã¢ãã°ããªã³ã®ç©æ¥µçæåãå§ããããã«ãªããŸãããã¢ãã°ããªã³ã®é å€ãåŠæ¹ããããã¢ãã°ããªã³ã®ç¹æ»ŽãããŠããŸããã²ã«ãããŠã ãšã®äœµçšã¯ãã°ããããŠãçã®çž®å°ãçããŒã«ãŒã®äœäžã®å ±åãã¡ãã»ãèŠãããããã«ãªããŸããã
ããã¯ã®çš®ãé£ã¹ãããã«ããŠãã ããããªã©ãšæ£è
ã«æå°ãããšãã¿ãªããäžæ§ã«é©ãããŸãã
æ²»çãžã®ç¬¬äžæ©ã¯ããŸããå
¬çæ©é¢ã«ããåèŠã®é€å»ãããã§ãã