Pregnancy specific beta 1-glycoprotein and alpha 2-pregnancy associated globulin in tumours of the female genital tract

Tumour tissues obtained from 35 patients with malignancies of the female genital tract were investigated for production of pregnancy specific beta 1-glycoprotein (PS beta 1G) and alpha 2-pregnancy associated globulin (alpha 2-PAG). PS beta 1G was found in all five trophoblastic tumours studied and in 10 of the 30 nontrophoblastic cancers. alpha 2-PAG was not detected in any of the neoplastic tissues. In 18 of the patients with non-trophoblastic tumours PS beta 1G and alpha 2-PAG serum concentrations were also determined. No correlation between serum and tissue findings were noted. Thus, PS beta 1G does not seem to be a valuable serum indicator for monitoring the extent or variation of tumour mass in nontrophoblastic gynecological malignancies. Likewise, alpha 2-PAG is unlikely to serve as a clinical useful tumour marker in various gynecological cancers.

[Behavior of the serum concentration of pregnancy associated alpha 2 glycoprotein (alpha 2-PAG) in gynecologic carcinomas (author's transl)]

The serum concentration of Alpha 2-PAG was measured in a group of women (n = 204) with different sites and types of gynecological carcinomas and various stages. In a follow-up study over a period of 2 years a positive correlation between Alpha 2-PAG serum concentration and clinical course was found in 50 of 139 woman (35.9%) only. These results suggest that Alpha 2-PAG is an unsatisfactory marker in a majority of the gynecological malignomas studied.

[The clinical significance of determination of red blood cell and urinary polyamines in gynecologic malignancy (author's transl)]

The polyamines spermidine (spd) and spermine (spm), and their diamine precursor, putrescine (put) were separately determined in red blood cells (RBC) and 24-hour urine samples of gynecologic malignant and non-malignant cases using high-pressure liquid chromatography (HPLC) technique. The results are as follows: 1) Patients with malignancy (49 cases) had the polyamine levels of RBC-spd; 5.85 +/- 3.32 (mean +/- SD), RBC-spm; 7.00 +/- 5.53 (nmol/ml packed RBC), urinary put; 3.92 +/- 4.13, urinary spd; 2.17 +/- 1.74 (mg/day) in pre-therapeutic state. These levels were greatly higher than those of control cases. 2) The diagnostic rate was 100% in the fourth stage of uterine cervical cancer, and 80% in the recurrent cases. 3) Patients with long-term abnormal polyamine levels had the tendency of poor prognosis. 4) In many cases, RBC polyamines and urinary polyamines showed somewhat different fluctuations in the course of treatment. In conclusion, it is suggested that the measurement of polyamines is very useful in the diagnosis of progressive cases and recurrent cases, and can be helpful in the evaluation of therapeutic effects and prognosis.

[The use of laser nephelometry for the determination and computer-assisted calculation of the fibronectin concentration in various body fluids (author's transl)]

We report a laser-nephelometric procedure for the determination of the concentration of fibronectin in various human and animal body fluids. The method is precise (CV intra-assay 2.1%), sensitive (the detection limit is 1.2 mg/l fibronectin), rapid, relatively simple and can be totally mechanized. By use of programmable calculators an electronic evaluation of the scattered light signals is possible. The antigen concentrations determined both by laser nephelometry and radial immunodiffusion show a coefficient of correlation of r = 0.859. In plasma of healthy men the mean concentration of fibronectin is 291 mg/l; women have a significant lower concentration of 259 mg/l. Increased levels of plasma fibronectin were found in patients with carcinomas of the female genital tract and Morbus Crohn. Synovial fluids obtained from inflammatory joint diseases contain significantly higher concentrations of fibronectin (318 mg/l) than those from non-inflammatory joints. The range of concentration of fibronectin in seminal plasma is similar to that in blood plasma, but a large inter-individual variation was observed. Extremely low antigen concentrations (0.41 mg/l) were determined in normal liquor cerebrospinalis, but under pathological conditions a significant increase occurs, which correlates strongly with the cell count. Low levels of fibronectin (16 mg/l) were also found in amniotic fluid at the end of pregnancy.

Early phase pharmacokinetics of doxorubicin (adriamycin) in plasma of cancer patients during single- or multiple-drug therapy

Doxorubicin (Adriamycin [AM]) was measured in plasma in the early distributive phase in 26 patients with different solid tumors. Pharmacokinetic parameters were calculated during first and/or subsequent courses of AM injected iv at doses from 40 to 60 mg/m2 either alone or with other antineoplastic agents. A fluorimetric technique was employed to determine AM equivalents; the reduced metabolite Adriamycinol was quantitated by scanning fluorescence after separation in thin-layer chromatography. The following conclusions are drawn from the findings. (a) After repeated AM treatments the individual variability in pharmacokinetic parameters of the drug did not appear to be affected by the length of treatment. (b) When the same patient was given different AM doses over a certain period some degree of dose dependence was seen only in the area under the curve and extrapolated plasma drug concentration at Time 0. (c) A narrow range of AM doses gave pharmacokinetic values differing from one patient to another. (d) After repeated AM treatments, Adriamycinol levels became lower, suggesting either a reduced metabolism of the parent compound or increased excretion of the reduced metabolite.

Acute reactive stage proteins in gynaecologic cancers

The authors report the plasmatic variations of ARPS (acute reactive proteins stage) in fifty eight women, admitted to the Obstetric and Gynaecological Clinic of Padua's University in the years 1978-1979 aged between 35 and 80 years old; those patients were affected by different types of gynaecological neoplasms: twenty three had cervical cancer, eight endometrial cancer, twenty six ovarian cancer. An evident increase was seen in the ARPS in the patients studied. In particular there was an increase in he haptoglobin in the ovarian cancer patients as well as an increase in the alpha-1 antitrypsin in the cervical cancer patients. Regarding ARPS and the clinical stage of the tumour the variations were important between T0 and T1 that is between tumours localized in the affected organ and those outside the primitive site but always in the pelvis. No evident alterations were found between T1 or T2; there was no other increase in the ARPS in neoplasm outside the pelvis.

Multiple biochemical markers in patients with gynecologic malignancies

Plasma levels of carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and human chorionic gonadotropin (hCG) were measured in 253 patients with gynecologic malignancies and in 317 patients with benign gynecologic diseases. Plasma concentrations of each of these antigens were elevated in a significantly (p less than 0.001) greater number of patients with invasive gynecologic cancers than in the control population. Carcinoembryonic antigen was the most commonly elevated marker, followed by AFP and hCG. Prior to therapy, over 85% of patients with ovarian or cervical cancer had elevated plasma levels of one or more antigens. Specifically, CEA was most often elevated in patients with mucinous adenocarcinomas of the ovary and endocervix. Alpha-fetoprotein was most often increased in patients with germ cell or stromal tumors of the ovary and in patients with large-cell nonkeratinizing cervical cancers. In contrast, hCG concentrations were highest in patients with serious cystadenocarcinomas of the ovary and in patients with keratinizing squamous cell carcinomas of the cervix. Plasma antigen levels were directly related to tumor differentiation and stage of disease, and generally returned to normal eight to 12 weeks following therapy. Effective plasma and tumor antigen screening during initial evaluation of patients with gynecologic tumors should help to identify the most appropriate antigen for immunodetection procedures and for serial plasma determinations following therapy.

Plasma prostaglandin F levels and malignant tumours of the female genital tract

Plasma prostaglandin F (PGF) was measured by a radioimmunoassay method in 24 subjects with tumours of the female genital tract. Levels in the tumour group ranged from 25 pg/ml to 134 pg/ml and were almost all greater than the values observed in a control group of 41 healthy women who had a mean (+/-SD) level of 21 (+/-3.4)pg/ml. There was a relationship between plasma PGF levels and the stage of the disease. Patients with resectable tumours showed a fall in PGF levels postoperatively and those with disseminated malignancy demonstrated increasing levels as the disease progressed. Plasma PGF may provide a clinical prognostic marker in the management of patients with malignant tumours.

Serum glycoprotein hormone alpha subunit levels in patients with cancer

The serum glycoprotein hormone alpha subunit concentration was measured in 957 nonpregnant patients with benign disorders and 683 patients with unselected malignancies. Postmenopausal women had significantly higher alpha levels than premenopausal women or men. When the patients were subdivided according to age, sex or disease sites, significant population differences were found for women less than 50 years of age and patients with cancers of presumed neural crest origin. However, individual serum alpha levels in patients with benign disorders or malignancies demonstrated considerable overlap. No population differences in serum alpha concentrations were demonstrated between patients grouped according to stage of disease, suggesting that serum alpha were not directly related to tumor burden. Similarly, there was no statistical association between clinical improvement or deterioration and change in the serum alpha subunit concentration. These results indicate that measurement of the glycoprotein hormone alpha subunit concentration in the serum is not useful for screening patients for cancer or for monitoring the clinical course of patients with the vast majority of cancers.

[Ozone-oxygen therapy for gynecologic carcinomas. The effect of parenteral-ozone oxygen mixture administration on free fatty acids and triglycerides in patients with gynecologic carcinomas]

As some authors suspect that ozone influences the metabolic process of fat, we tried to analyse the influence of an ozone-oxygen gas which was applied parenterally. 40 patients with gynecological cancer received 10 ml ozone-oxygen gas with a content of 450 gamma ozone and venous blood was removed before and 10 minutes after application. The serum was lyophilized and the level of fatty acids and triglycerids was determined by the method of Randerath (1965). a statistically significant decrease of the concentrations was observed after application of ozone. Different theories as to the cause of this action are discussed.

Carcinoembryonic antigen and beta 2-microglobulin as serum tumor markers in women with genital cancer

A comparative study of carcinoembryonic antigen (CEA) and beta 2-microglobulin (beta 2-MG) in serum was made by radioimmunoassay in 77 women with genital cancer. With a positive level defined as 5 ng of CEA/ml and 3.0 microgram of beta 2-MG/ml, CEA was positive in 31% of the women with cancer of the corpus, 36% of those with cancer of the cervix and 36% of those with cancer of the ovary the corresponding figures for beta 2-MG were 6%, 27% and 56%, respectively. The additional use of beta 2-MG provided an increase in positive results, especially in cases of cancer of the ovary. A direct relationship between the extent of tumor and serum marker level was more evident for beta 2-MG than CEA. There was no correlation between serial levels of CEA and beta 2-MG in most patients. CEA levels appeared to predict subsequent tumor behavior more accurately in patients with good prognoses (ie, complete or partial tumor response), whereas beta 2-MG levels gave the same prediction in those with bad prognoses (ie, nonresponsive or progressive tumor).

F cells in gynaecologic malignancy

Red cells containing Hb F (F cells) were detected by immunofluorescence using a specific antiserum. In normal persons, the number of F cells was 2.5 +/- 1.1%. A significantly increased number of F cells was found in 65% of patients with cancer of the ovary, 69% of patients with cancer of the endometrium and in 22% of patients with cancer of the cervix. Highest values were obtained in cancer of the ovary and endometrium. There was no correlation between the number of F cells and stage of disease or degree of differentiation. It is postulated that in patients with malignant disease a humoral factor is produced which interferes with normal erythropoiesis resulting in a process of dedifferentiation.

[Pregnancy associated alpha2-glycoprotein (alpha2-PAG) in the serum of patients with gynecologic carcinomas]

alpha2-PAG is a high-molecular, carbohydrate-containing glycoprotein. It occurs in traces in normal human serum. The variations in serum levels of this protein were studied during treatment of 32 gynecological cancer patients in the course of 2 years. The periodic alpha2-PAG determinations were done with an electro-immuno-assay. A correspondence between alpha2-PAG serum levels and the clinical course could be found in 60%. In 5 of 13 patients who did not respond to therapy alpha2-PAG levels rose, additional 4 had unchanged high levels, whereas 13 of 17 patients had significantly decreased levels on successful treatment. The relevance of periodic alpha2-PAG determinations is discussed.

[Haptoglobins in gynecologic tumors (author's transl)]

Serum concentrations of haptoglobins were checked in 100 women with benign or malign gynecologic tumors. Typification of haptoglobins was determined by starch gel electrophoresis, quantification by single radial immunodiffusion. Cases with malignancies showed significant increased levels in comparison to healthy women. In cases with cervical carcinoma, a significant increase of the haptoglobin level was evaluated according to advanced carcinoma.

On the occurrence of the pregnancy zone protein (PZ) in gynecological cancer

Reports have been made that the pregnancy zone protein (PZ) is found in increased amounts in sera of patients with malignant disease. The serum concentration of PZ was measured by a radioimmunoassay in 83 women with the diagnosis of gynaecological cancer or other malignancies. Values did not significantly differ from values previously recorded in apparently healthy women. There was no support for previous data of increased levels of PZ in cancer patients, when the age-dependent increase of this serum factor was considered.

[The serum copper/serum iron ratio in malignant tumors of the female genitalia]

Copper and iron in blood of 83 women with maligne tumors of the genitalia were regulary controled before, during and till 69 weeks after therapy. The relation between the copper/iron-ratio and the expansion and histology of the tumors, the success of the therapy and the incidence of a recurrence was checked for any significancy. Our results show the improtance of the ratio in the diagnosis and differentialdiagnosis of the ovarian-cancer and the corpus-uteri-cancer, and in the success-controll during tumor-therapy. In the group of the patients with collum-uteri-cancer we found a significant difference in the copper/iron-ratio of the patients with and without a recurrence during the controllperiod after therapy, which emphasizes the importance of this copper/iron-ratio.