Acid phosphatase in prostatic tissue homogenates from patients with benign prostatic hyperplasia and prostatic carcinoma

Prostatic intraepithelial neoplasia and other changes during promotion and progression

Preneoplastic lesions, early neoplastic lesions and carcinomas in situ have been demonstrated to be of great value for many purposes in many organ systems. Their recognition can be useful in epidemiological studies and can facilitate the selection of patients for therapeutic interventions. They can be used as "surrogate endpoint biomarkers" in studies aimed at the chemoprevention of cancers. In the lung, colon and various other organs, such markers are well recognized to be associated with the development of cancer in man. In the livers and colons of experimental animals, there has been detailed characterization of "enzyme-altered foci" (EAF) as "putative preneoplastic markers." The words "surrogate" and "putative" are important; the biological potential of these lesions needs to be elucidated in much greater detail. The quantification of early lesions that are associated with and sometimes precursors of neoplasia is of particular value because they are much more numerous, in most organ systems, than the carcinomas that develop in the same organs. The most abundant of these lesions show minimal or no morphological alterations. For example, EAF and aberrant crypts are more numerous than polyps in the colons of patients and experimental animals with cancer or precancerous conditions that affect the colon. Currently, there are few well documented putative or surrogate markers that are highly associated with the development of prostatic carcinoma in man. The best documented among these is prostatic intraepithelial neoplasia. We have recently reported the identification of EAF in the human prostate. While they share many phenotypic alterations with prostatic intraepithelial neoplasia, much remains to be accomplished if their biological fate is to be understood.

Study of activities of arginase, hexosaminidase, and leucine aminopeptidase in prostate fluid

Our previous studies demonstrated that extracts of the cancerous prostate tissues exhibit increased activities of arginase and hexosaminidase and decreased activity of leucine aminopeptidase. In an endeavor to devise a reliable, noninvasive and cost effective method for the diagnosis of prostate carcinoma, prostate fluids collected from 123 patients were analyzed for arginase, hexosaminidase, and leucine aminopeptidase. Based on the clinical diagnoses, the patients were divided into four groups: 13 men with chronic prostatitis, 29 with no recognized prostatic lesions, 63 with benign prostatic hyperplasia, and 18 with prostate cancer. The prostate fluids had no detectable arginase activity. The means of the total (units/mL) and the specific activities (units/mg of protein) of hexosaminidase and leucine aminopeptidase varied, albeit there were no significant differences in the four groups of patients recruited in this study. It was concluded that the profiles of enzymes in prostate fluids might differ from that in the secreting prostate tissues and that the results of enzyme analysis in prostate fluids for the diagnosis of cancer should be interpreted with caution.

Prostatic acid phosphatase, beta-glucuronidase and prostate specific antigen assays in fine needle aspirates from benign and malignant prostates

Enzymatic assays for tartrate-sensitive acid phosphatase and beta-glucuronidase, and radio-immunoassay for prostate-specific antigen, were modified for application to fine-needle aspirate samples from benign and malignant human prostates. When compared to samples from benign prostates, the ratio of acid phosphatase to beta-glucuronidase activities was significantly decreased in needle aspirates from malignant prostates. Prostate-specific antigen values in the aspirates did not correlate with malignancy.

Differences in the leucine aminopeptidase activity in extracts from human prostatic carcinoma and benign prostatic hyperplasia

Extracts of tissue showed that prostatic carcinomas contain less leucine aminopeptidase activity than benign prostatic hyperplasia. This is true when activity is expressed as specific activity (P = 0.0033), specific activity/% epithelium (P = 0.0007), activity/wet weight of tissue (P = 0.0028), or activity/wet weight of tissue/% epithelium (P = 0.0005). Almost all histochemically demonstrable activity is located in the epithelium. Enzymatic activities in extracts and in histochemical preparations showed similar differences between carcinoma and benign prostatic hyperplasia and were related (R = -0.38, P = 0.0400) to Gleason's grades. The transurethrally resected prostate cancers studied contained no well-differentiated tumors and a high proportion of poorly differentiated tumors. Histochemical activity is absent in most prostatic carcinomas and decreased in others. This observation is particularly interesting in view of the growing knowledge of tumor suppressor genes.

Changes in biochemical markers of hyperplastic and malignant prostatic tissues

Some biochemical markers were evaluated in human prostatic tissue obtained from patients with benign hyperplasia. There was an almost threefold increase in the activity of acid phosphatase of these patients as compared to that of normal men. The changes in the acid phosphatase activity were directly correlated with citric acid concentration. Significant (p less than 0.001) increases in the content of citric acid, zinc, and calcium in benign hyperplastic prostates was found. There was no change in the activity of aminopeptidase. The activities of both enzymes were lower in malignant prostatic tissues.

Enzymatic activities in extracts of small (20 +/- 5 mg) samples of prostatic carcinoma

Previously, we reported that the activities of several enzymes extracted from prostatic cancers were closely related to the histologic grades (Gleason's grades) of the cancers. The survival of patients was more closely correlated with certain enzymatic activities than with Gleason's grades. Unfortunately, because our assays required relatively large amounts of tissue, the increasing proportion of patients who have needle biopsies as their only surgical procedure had to be excluded from our previous study. We now report a method that permits multiple enzyme assays to be carried out with much smaller amounts of tissue. This method will enable us to avoid the selection inherent in the exclusion of patients who have only needle biopsies and should permit the prospective study of most patients with prostatic carcinoma.

Beta-glucuronidase activity in prostatic carcinoma and benign prostatic hyperplasia

Beta-glucuronidase activity was extracted from prostatic carcinomas and hyperplastic prostates. It was 3.6-fold higher (P less than 0.0001) in prostatic carcinoma than in prostatic hyperplasia. Analysis for isoenzymes of prostatic beta-glucuronidase by disc-gel electrophoresis in nondenaturing polyacrylamide gels demonstrated only one form of the enzyme. Histochemically, enzymatic activity was observed almost entirely in epithelial cells in both prostatic carcinoma and benign prostatic hyperplasia.

Discrimination between normal, hyperplastic and malignant human prostatic tissues by enzymatic profiles

A relative enzymatic index has been developed which differentiates normal, hyperplastic (BPH) and malignant human prostatic tissues. Enzymatic activities have been calculated at Vmax conditions in 10 normal, 14 BPH and 11 carcinoma samples. Five enzymes have been assayed: 1) 5 alpha-reductase, 2) 3 alpha-hydroxysteroid oxidoreductase, 3) 3 beta-hydroxysteroid oxidoreductase, 4) 17 beta-hydroxysteroid oxidoreductase and 5) acid phosphatase. The following observations were made when comparing individual enzymatic activities between the 3 tissue groups: 1) mean 5 alpha-reductase activity was lower in carcinoma than in both normal prostate and BPH (p less than 0.05), 2) mean 3 alpha-hydroxysteroid oxidoreductase and 3 beta-hydroxysteroid oxidoreductase activities were greater in carcinoma than in BPH (p less than 0.05) and 3) mean acid phosphatase activity was higher in BPH than in both normal prostate and carcinoma (p less than 0.01). The absolute enzymatic activities were then expressed as relative activities by dividing each absolute value by the mean value for that enzyme in normal prostatic tissue. Relative enzymatic activities were used to derive the ratio: (Formula: see text) The mean value of this ratio was statistically different in normal, BPH and carcinoma tissue (p less than 0.01). The mean value was 3.6 times higher in BPH than in normal tissue, and was 3.8 times higher in normal tissue than in carcinoma. This suggests that BPH and carcinoma diverge in opposite directions biochemically from normal prostatic growth and supports histologic evidence that the 2 neoplastic conditions have a different pathogenesis rather than being part of the same disease spectrum.