Immunohistochemistry of human gastrointestinal cancer-associated antigen detected by monoclonal antibody PA 8-15

A murine monoclonal antibody (MAb), PA 8-15, was produced against a newly established human pancreatic adenocarcinoma cell line, SUIT-2. With the avidin-biotin immunoperoxidase technique, PA 8-15 MAb reacted strongly with 27 of 28 formalin-fixed paraffin-embedded pancreatic adenocarcinoma tissues. All six gall bladder carcinomas and all nine biliary tract carcinomas also showed positive reactions. In addition, PA 8-15 MAb reacted with gastric carcinomas (6/10), colorectal carcinomas (7/11), and some other primary adenocarcinomas. The distribution of PA 8-15 antigen on the same tissues of pancreatic cancer was different from those of CA 19-9 and DU-PAN-2 antigens and CEA. PA 8-15 MAb stained only the epithelium of the pancreatic duct, gall bladder and bile duct in normal adult tissues, and some normal fetal glandular epithelial cells. However, PA 8-15 MAb was not reactive with inflammatory or benign tumors of the digestive system except for the epithelium, as was seen in normal adults. Reactivity of PA 8-15 MAb with tissue specimens largely disappeared after treatment with neuraminidase, while oxidation with periodate or trypsin digestion did not alter the staining intensity, indicating that antigenic determinants may be at least partly of sialylated carbohydrate nature. These results suggest that PA 8-15 MAb detects a new oncofetal antigen in gastrointestinal cancers, especially of the pancreatico-biliary tract.

[Studies of enzymuria and proteinuria: Report 1: N-acetyl-beta-glucosaminidase in urological diseases]

N-Acetyl-beta-glucosaminidase (NAG) exists in renal tubules and seminal tract. We measured the NAG level in patients with urinary tract and seminal tract diseases and evaluated its clinical significance. The urinary NAG level was high in renal tubular function disorders such as glomerulonephritis, diabetic nephropathy and hydronephrosis. In these patients, NAG-isoenzyme studies indicated that the A-type isoenzyme decreased while the B-type isoenzyme increased. On the other hand, in the seminal tract disease patients, the urinary NAG level was high in benign prostatic hypertrophy with a catheter indwelling and in prostatitis. Urinary and seminal NAG-isoenzymes were measured in normal subjects. The isoenzyme patterns for urinary NAG and seminal NAG differed. The urinary NAG isoenzymes were measured in acute prostatitis patients, we found that the A-type isoenzyme decreased and the B type increased. In conclusion, when the A/B ratio of the NAG-isoenzyme is close to 24.9/75.0 in the urine, the presence of urological diseases in which seminal plasma could be mixed in, especially prostatic diseases, should be suspected.

Comparative effectiveness of the tumour diagnostics, CA 19-9, CA 125 and carcinoembryonic antigen in patients with diseases of the digestive system

Serum concentrations of CA 19-9, CA 125 and carcinoembryonic antigen (CEA) in 145 patients with gastrointestinal carcinomas and 89 with non-neoplastic diseases were determined to compare the clinical usefulness of these tumour markers. Significantly fewer positive cases were obtained with serum CA 19-9 (9%) and CA 125 (8%) tests than the CEA test (22%) (both p less than 0.05) in patients with benign diseases, while comparable sensitivities were achieved with the CA 19-9 (44%) test, the CA 125 (41%) test and the CEA test (47%) in those with a carcinoma. High incidences of raised concentrations of serum CA 19-9 and CA 125 were observed in case of cancer of the pancreas (CA 19-9: 87%, CA 125: 67%) and biliary tract (CA 19-9: 63%, CA 125: 48%). Combined tests of CA 19-9 and CA 125 revealed increments in the sensitivity (61%) and provided a higher specificity (87%) than that of the single CEA test (78%). These combined tests were most useful for a differential diagnosis of pancreatic carcinoma (97% positive) and biliary tract carcinoma (74%) from chronic pancreatitis (4%) and cholelithiasis (0%), respectively. Studies on the relations of clinical staging and serum concentrations of CA 19-9 and CA 125 revealed significant rises in cases of disseminated carcinoma. These results clearly show that serum CA 19-9 and CA 125 tests are most pertinent for diagnosing advanced carcinomas of organs in the digestive system.

Clinical significance of serum CA125 values in patients with cancers of the digestive system

A study of 347 patients with gastrointestinal diseases revealed elevation of CA125 in sera of 63% of patients with pancreatic carcinoma, 46% of patients with carcinoma of the biliary tract, 40% of patients with liver carcinoma and 11-37% of patients with other carcinomas. All of the patients with acute pancreatitis, chronic pancreatitis, cholelithiasis, and peptic ulcer had normal CA125 values, but 35% of patients with liver cirrhosis and 10% of patients with chronic active hepatitis had elevated values. Patients with disseminated carcinomas had significantly higher levels than patients with localized carcinomas. CA125 did not significantly correlate with CA19-9 or carcinoembryonic antigen in patients with pancreatic carcinoma. Ninety-seven percent of patients with pancreatic carcinoma were defined as being positive when both serum CA125 and CA19-9 were evaluated. These results indicate that CA125 is useful for differentiating pancreatic carcinoma from chronic pancreatitis, especially when supplemented with CA19-9.

Evaluation of serum CA125 values in healthy individuals and pregnant women

CA125 is an antigenic determinant associated with human epithelial ovarian carcinoma. This study was undertaken to evaluate the distribution of serum CA125 levels and the effect of smoking on these levels among healthy individuals and clarify the relation of maternal serum CA125 level and pregnancy. Among 552 healthy individuals, the distribution of serum CA125 values was demonstrated to resemble logarithmic normal distribution. Analysis of variance about age and sex revealed apparent elevation of values for women under 49 years of age in comparison with those for women over 50 years of age and men. Values for these two groups were 143 units/ml for the former and 32 units/ml for the latter, with a 99.7% confidence limit. These values exclude 99.3% of the former and 99.7% of the latter. Serum CA125 values were not affected by smoking. The measurement of serum CA125 levels in 71 pregnant women disclosed a significant elevation during the first trimester in comparison with nonpregnant women under 49 years of age. These results indicate that CA125 values must be deliberatively evaluated in young women, especially during first trimester of pregnancy.

Colony-stimulating factor producing carcinoma of the gallbladder

A patient with an anaplastic carcinoma of the gallbladder accompanied by marked neutrophilia was found to have high colony-stimulating factor (CSF) activity in the urine and serum. The supernatant of the cultured tumor cells (6th passage) showed high and specific CSF activity. These specimens induced the formation of granulocyte colonies, macrophage colonies or granulocyte-macrophage mixed colonies by both human and C57BL mouse bone marrow cells in soft agar. These results suggest that this tumor is a human granulocyte-macrophage (GM)-CSF producing tumor.

Establishment of a cell line of gallbladder carcinoma (GBK-1) producing human colony stimulating factor

A cell line designated GBK-1 was established from a patient with anaplastic carcinoma of the gallbladder, marked neutrophilia and fever, and has been propagated for the past 18 months. The cells grew as a monolayer sheet with a doubling time of 43 hr. The GBK-1 cells were of a pleomorphic polygonal epitheloid shape and they were transplantable into nude mice. Mice bearing the tumor developed marked granulocytosis. In the culture supernatant of GBK-1 cells, high colony stimulating factor (CSF) activity was evident with both human bone marrow cells and C57BL mouse bone marrow cells, and granulocytic colonies, macrophage colonies or granulocyte-macrophage mixed colonies were produced. The CSF activity was distributed in the molecular weight range of 25,000 to 60,000 with two distinct peaks at molecular weights of approximately 50,000 and 30,000. CSF activity was inactivated by heat treatment at 70 degrees for 30 min. GBK-1 is a new human cell line that produces heat-labile human GM-CSF.

Myoglobin oxygenation remains constant during the cardiac cycle

Oxygen saturation of myoglobin (Mb) during the cardiac cycle was recorded spectrophotometrically by incorporating fiber optics in the isolated rat heart perfused using the Langendorff procedure. Oxygen saturation of Mb was continuously measured from absorbancy increments at 581-592 nm of transmitted light through the left ventricular free wall. In addition, quantification in the Mb oxygen saturation induced by the change of wall thickness during cardiac cycle was assessed from the absorbance change at 568-592 nm, namely, dual wavelengths of two isosbestic points. The results show that to obtain actual Mb oxygen saturation the absorbance change induced by the change in the wall thickness has to be subtracted from the absorbance change of 581-592 nm and that the Mb oxygen saturation in a steady state determines the amount of subtraction. On the basis of these procedures, it was found that the myocardial Mb oxygen saturation and hence myocardial oxygen tension during pulsation in aerobic and anaerobic steady state did not vary during the cardiac cycle.

Regional myocardial function and metabolism during acute coronary artery occlusion

Regional changes in myocardial function and oxidative metabolism during acute coronary artery occlusion were recorded spectrophotometrically by incorporating fiber optics in the isolated rat heart perfused by Langendorff's procedure. Oxygen saturation of myoglobin, reduction of cytochrome aa3, and the dynamic wall thickness of the left ventricle were continuously and concurrently measured from absorbancy increments at 581-592 nm, 605-630 nm, and 568-592 nm, respectively. In contrast to a gradual decrease in the extent of systolic wall thickening in anoxia, observed decreases in both the extent and the duration of systolic wall thickening and the appearance of a late systolic bulge occurred within 5 s after the onset of regional ischemia. After 10 s of both anoxia and regional ischemia, oxygen saturation of myoglobin decreased by 50%, but fluorescence of nicotinamide adenine dinucleotide remained at aerobic level which indicated that mitochondrial oxidative energy production might still be maintained. Thus early and pronounced dysfunction of the ischemic region appeared to precede a substantial loss of ATP production.

Stimulation of protein and RNA synthesis by methylmercury chloride in the liver of intact and adrenalectomized rats

(1) A single injection of methylmercury chloride in the rat (10-50 mg/kg) increased both in vivo and in vitro rates of 14C-leucine incorporation into the protein of the post-mitochondrial supernatant fraction of the liver. In contrast, no stimulation of protein synthesis was observed in the brain of the methylmercury-treated rats. (2) Methylmercury administration also stimulated RNA polymerase activities in isolated hepatic nuclei, stimulation of Mg-dependent activity being higher than that of Mn-dependent activity. (3) In experiments with adrenalectomized rats, it was found that the stimulatory effect of methylmercury on protein and RNA synthesis in the liver was mediated partly through the adrenal gland. (4) Analysis of serum by starch-block electrophoresis revealed that synthesis of all serum proteins, including albumin and alpha-gamma globulin fractions, was stimulated by methylmercury treatment. (5) These results suggest that the observed effects of methylmercury on the liver depend on mechanisms other than enhancement of the synthesis of acute-phase proteins.

Studies on hemorrhagic tendency in cirrhosis of the liver

Recently it has been paid attention whether the liver diseases might induce the disseminated intravascular coagulation (DIC) or not, although it has well known that liver cirrhosis contribute to the hemorrhagic diathesis. In this paper, we studied on the hemorrhagic tendency and hemostatic tests in the patients with liver cirrhosis in order to clarify the coagulation and fibrinolytic activity. We can conclude that the hemorrhagic diathesis occurs due to the complex of decreases in platelet number, platelet functions, clotting factors, and increased fibrinolytic activity. The increased fibrinolytic activity may be primary and the frequency of clinically important DIC is quite low.