- 學位論文
探討α1酸性醣蛋白與血清澱粉樣蛋白A於外表健康及罹患腫瘤貓隻之應用
Clinical Application of Alpha 1–Acid Glycoprotein and Serum Amyloid A in Apparently Healthy Cats and Cats with Neoplasia
摘要
急性期蛋白常用於組織損傷的篩檢與監測，而在人健康檢查中也會將此項目做為慢性疾病的風險標誌，也可被用於腫瘤的評估。α1酸性醣蛋白（Alpha 1–Acid Glycoprotein, AGP）與血清澱粉樣蛋白A（Serum Amyloid A, SAA）是貓的主要急性期蛋白，但相關臨床應用的研究並不多，本次研究將探討AGP及SAA於老年貓隻健康檢查以及腫瘤疾病的臨床應用價值。試驗方法分別為（一）募集外表健康的老年貓隻（>7歲）進行AGP、SAA檢驗、理學檢查、全血球細胞計數、血清生化、X光、全身電腦斷層掃描，以及嘗試進行關節囊液檢測來評估動物是否有潛在疾病。本試驗共募集16隻貓，有13隻貓在影像中可見患有潛在疾病，其中7隻患有關節炎、呼吸道炎症、腹腔異質性團塊，且AGP有異常升高，其他無潛在疾病的貓的AGP則是正常。所有貓隻SAA數值都在正常範圍內。此外關節囊液的檢查較不具臨床價值。（二）收集患有腫瘤的貓隻血漿中SAA、AGP及細胞激素的濃度，再依據斷層掃描結果中腫瘤轉移結果分組，此外納入過去研究中健康貓隻AGP的數據作為基準，以統計學分析APP、細胞激素與腫瘤的相關性。本試驗共納入30隻貓，結果顯示有22隻貓（73%）的AGP異常上升，其中16隻貓（73%）發現轉移，只有4隻貓（13%）的SAA異常上升，其中3隻貓（75%）發現轉移。患有腫瘤貓隻AGP的濃度較健康貓隻高，但APP的濃度與腫瘤轉移與否、存活時間及細胞激素濃度間並無相關性。研究結論為貓急性期蛋白AGP可提供健檢作為潛在疾病的篩檢工具及腫瘤輔助診斷，但並不適合作為腫瘤預後的評估標準，此外SAA雖一般被認為是敏感性較高的貓急性期蛋白，但在健檢及腫瘤評估的臨床應用價值應不高。
並列摘要
Acute phase proteins (APPs) can be used to detect and monitor tissue damage. It also can be included in regular human health screening as a biomarker for chronic disease and neoplasia. Alpha 1–acid glycoprotein (AGP) and serum amyloid A (SAA) are two major acute phase proteins in cats, but studies for clinical application were limited. This study will explore the values of AGP and SAA in health screening for elderly cats and cats with neoplasia diseases. First, > 7 years old, apparently healthy mature cats were recruited, and plasma AGP and SAA values were measured. The potential underlying diseases was diagnosed through physical examination, complete blood cell count, serum biochemistry, and whole-body computed tomography. Synovial fluid was also analyzed if possible. Finally, 16 cats were recruited. Underlying diseases were found in 13 cats and 7 cats of them which were diagnosed with arthritis, respiratory tract inflammation, and abdominal mass via radiological examination, had elevated AGP values. Normal AGP values were found in the cats without underlying diseases. SAA values were within normal range in all cats. Second, cats with neoplasia and undergone CT examination were recruited. Plasma AGP, SAA and cytokines values were measured and grouped by metastasis status. In addition, the AGP values of health cats in previous study was applied as a control group. 30 cats were recruited. Elevated AGP and SAA values were noted in 22 (73%) and 4 cats (13%), and 16 (73%, 16/22) and 3 (75%, 3/4) cats were diagnosed with metastasis respectively. AGP increased significantly in cats with neoplasia, but there was no low correlation between the metastasis, survival time and cytokines. In conclusion, AGP can provide as a tool for screening potential diseases during health examination and an auxiliary diagnosis method of neoplasia. However, it is not applicable for giving the prognosis of neoplasia. Although SAA is generally considered as a more sensitive feline acute phase protein, its clinical values in health examinations and tumor assessment may be low.
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