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Okamoto M, Yamaguchi S, Ishi Y, Motegi H, Mori T, Hashimoto T, Terashita Y, Hirabayashi S, Sugiyama M, Iguchi A, Cho Y, Manabe A, Houkin K. Diagnostic Capability of Cerebrospinal Fluid-Placental Alkaline Phosphatase Value in Intracranial Germ Cell Tumor. Oncology 2020; 99:23-31. [PMID: 32906115 DOI: 10.1159/000509395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/11/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Most types of intracranial germ cell tumors (IGCTs) are sensitive to chemoradiation. However, biopsy specimens are usually small and thus cannot be used for obtaining an accurate pathological diagnosis. Recently, the cerebrospinal fluid (CSF) placental alkaline phosphatase (PLAP) value has been considered a new biomarker of IGCTs. The present study aimed to evaluate the discriminatory characteristics of the CSF-PLAP value upon diagnosis and at the time of recurrence in patients with IGCTs. METHODS Between 2015 and 2019, this study included 37 patients with tumors located in the intraventricular and/or periventricular region. The CSF-PLAP level was assessed before the patients received any treatment. The PLAP level was evaluated during and after first-line chemoradiotherapy in 7 patients with IGCTs. The CSF-PLAP values were compared according to histological diagnosis, and the correlation between these values and radiographical features was assessed. The CSF-PLAP values of 6 patients with IGCTs with suspected recurrence were evaluated based on neuroimaging findings. RESULTS The CSF-PLAP values were significantly higher in patients with IGCTs than in those with other types of brain tumor (n = 19 vs. 18; median: 359.0 vs. <8.0 pg/mL). The specificity and sensitivity were 88 and 95%, respectively, with a cutoff value of 8.0 pg/mL. In patients with IGCT, the CSF-PLAP value was higher in patients with germinoma than in those with nongerminomatous germ cell tumors (n = 12 vs. 7; median: 415.0 vs. 359.0 pg/mL). Regarding the time course, the CSF-PLAP value decreased to below the detection limit after the reception of first-line chemoradiotherapy in all 7 patients. A significant correlation was observed between the initial CSF-PLAP value and the tumor reduction volume after receiving first-line chemoradiotherapy (p < 0.0003, R2 = 0.6165, logY = 1.202logX - 1.727). Among the patients with suspected IGCT recurrence (n = 6), the CSF-PLAP value was high in patients with recurrence (n = 3; median: 259.0 pg/mL), and that in patients (n = 3) without recurrence was below the lower detection limit. CONCLUSIONS The CSF-PLAP level is a useful biomarker during the initial diagnosis of IGCTs and at the time of recurrence. It may be associated with the volume of germinomatous components of tumors.
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Affiliation(s)
- Michinari Okamoto
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shigeru Yamaguchi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan,
| | - Yukitomo Ishi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroaki Motegi
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takashi Mori
- Department of Oral Radiology, Hokkaido University Hospital, Sapporo, Japan.,Department of Radiation Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Hashimoto
- Department of Radiation Medical Science and Engineering, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Radiation Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yukayo Terashita
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shinsuke Hirabayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Minako Sugiyama
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akihiro Iguchi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuko Cho
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Stinghen ST, Moura JF, Zancanella P, Rodrigues GA, Pianovski MA, Lalli E, Arnold DL, Minozzo JC, Callefe LG, Ribeiro RC, Figueiredo BC. Specific immunoassays for placental alkaline phosphatase as a tumor marker. J Biomed Biotechnol 2010; 2006:56087. [PMID: 17489017 PMCID: PMC1559920 DOI: 10.1155/jbb/2006/56087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human placental (hPLAP) and germ cell (PLAP-like) alkaline
phosphatases are polymorphic and heat-stable enzymes. This study
was designed to develop specific immunoassays for quantifying
hPLAP and PLAP-like enzyme activity (EA) in sera of cancer
patients, pregnant women, or smokers. Polyclonal sheep anti-hPLAP
antibodies were purified by affinity chromatography with whole
hPLAP protein (ICA-PLAP assay) or a synthetic peptide (aa 57–71)
of hPLAP (ICA-PEP assay); the working range was 0.1–11 U/L
and cutoff value was 0.2 U/L EA for nonsmokers. The intra-
and interassay coefficients of variation were 3.7%–6.5%
(ICA-PLAP assay) and 9.0%–9.9% (ICA-PEP assay). An
insignificant cross-reactivity was noted for high levels of
unheated intestinal alkaline phosphatase in ICA-PEP assay. A
positive correlation between the regression of tumor size and EA
was noted in a child with embryonal carcinoma. It can be concluded
that ICA-PEP assay is more specific than ICA-PLAP, which is still
useful to detect other PLAP/PLAP-like phenotypes.
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Affiliation(s)
- Sérvio T. Stinghen
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
| | - Juliana F. Moura
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
| | - Patrícia Zancanella
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
| | - Giovanna A. Rodrigues
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
| | - Mara A. Pianovski
- Division of Pediatric Hematology and Oncology,
Department of Pediatrics, Federal University of Paraná,
Curitiba, PR, CEP 80060-000, Brazil
| | - Enzo Lalli
- Institut de Pharmacologie Moléculaire et
Cellulaire, CNRS UMR 6097, 06560 Valbonne Sophia
Antipolis, France
| | | | - João C. Minozzo
- Center for Research and Production of
Immunoglobulins (CPPI), Rua Targino da Silva s/n, Piraquara, PR, CEP 83302-160, Brazil
| | - Luis G. Callefe
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
| | - Raul C. Ribeiro
- St. Jude Children's Research Hospital, Department of Hematology and Oncology and International Outreach Program,
332 North Lauderdale, Memphis, TN 38105, USA
| | - Bonald C. Figueiredo
- Centro de Genética Molecular e Pesquisa do
Câncer em Crianças (CEGEMPAC), Rua Agostinho Leão
Júnior, 400 Alto da Glória, Curitiba, PR, CEP 80030-110,
Brazil
- Research Institute
Pelé Pequeno Príncipe (IPPP), Avenida Silva Jardim, 1632
Água Verda, Curitiba, PR, CEP 80250-200, Brazil
- *Bonald C. Figueiredo:
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Application of stem cell markers in search for neoplastic germ cells in dysgenetic gonads, extragonadal tumours, and in semen of infertile men. Cancer Treat Rev 2008; 34:348-67. [PMID: 18289797 DOI: 10.1016/j.ctrv.2007.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2007] [Revised: 12/17/2007] [Accepted: 12/18/2007] [Indexed: 01/08/2023]
Abstract
Germ cell tumours (GCTs) are a complex entity. Current areas of attention include early detection and avoidance of unnecessary over-treatment. Novel findings regarding diagnosis of GCTs located in various anatomical sites are described, particularly testicular GCTs and their common progenitor, carcinoma in situ (CIS). Recognition of CIS enables intervention before tumour development, but nevertheless, testicular GCTs are sporadically diagnosed at the pre-invasive stage where minimal treatment is necessary. As presence of CIS is asymptomatic, a simple screening method is needed when CIS is suspected (i.e. in males investigated for infertility). To develop approaches for early detection CIS gene expression studies have been performed showing many similarities with embryonic stem cells with confirmation of established markers (i.e. PLAP, OCT-3/4, KIT) and identification of novel markers (i.e. AP-2 gamma, NANOG). We have reported a very promising new approach of AP-2 gamma (or OCT3/4) based immunocytological semen analysis (specificity 93.6%, sensitivity 54.5%). Comparative studies of gonadal/extragonadal GCTs have revealed resemblance pointing towards similar, but not identical, origins. Moreover, infertility and testicular cancer are connected in the 'Testicular Dysgenesis Syndrome' and 25% of contralateral testes from testicular GCT patients harbour dysgenetic features, including impaired spermatogenesis. Thus, recent data have provided potential diagnostic tools including CIS detection in semen, microarray-based tumour classification, additional serological GCT markers, and novel stem cell markers for immunohistochemical diagnosis of gonadal and extragonadal GCTs. Many CIS candidate genes are yet uninvestigated, and information from these could increase knowledge about CIS tumour initiation/progression and be used for optimisation of a non-invasive detection method.
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Zorzi W, Thellin O, Coumans B, Melot F, Hennen G, Lakaye B, Igout A, Heinen E. Demonstration of the expression of CD95 ligand transcript and protein in human placenta. Placenta 1998; 19:269-77. [PMID: 9639322 DOI: 10.1016/s0143-4004(98)90058-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Tolerance of the fetal allograft enables the human conceptus to implant itself into the maternal uterus and survive and grow there. This tolerance phenomenon remains largely obscure, notably because it appears to be controlled by multiple mechanisms. CD95 ligand (CD95-L), which can trigger death of CD95-positive cells by apoptosis, may participate in inducing anti-fetus-sensitized CD95-positive T lymphocytes to enter apoptosis. Using immunohistochemistry (first trimester and term placentae), FACS assays (term placenta) and RT-PCR assays (term placenta), the presence of CD95-L protein and mRNA has been shown in crude placental tissue preparations and isolated placental cells. Among the latter, CD95-L expression was detected in trophoblastic cells, fetal blood cells (mRNA only) and also the Hofbauer macrophages. No CD95-L was detected in fibroblasts or fetal endothelial cells. Thus trophoblastic cells, Hofbauer macrophages, and perhaps also fetal blood cells could form a sequential barrier blocking maternal activated defence cells bearing CD95 molecules.
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Affiliation(s)
- W Zorzi
- Institute of Human Histology, University of Liège, Belgium
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Van Hoof VO, De Broe ME. Interpretation and clinical significance of alkaline phosphatase isoenzyme patterns. Crit Rev Clin Lab Sci 1994; 31:197-293. [PMID: 7818774 DOI: 10.3109/10408369409084677] [Citation(s) in RCA: 163] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Alkaline phosphatase (ALP, EC 3.1.3.1) is a membrane-bound metalloenzyme that consists of a group of true isoenzymes, all glycoproteins, encoded for by at least four different gene loci: tissue-nonspecific, intestinal, placental, and germ-cell ALP. Through posttranslational modifications of the tissue-nonspecific gene, for example, through differences in carbohydrate composition, bone and liver ALP are formed. Nowadays, most commercially available methods for separating or measuring ALP isoenzymes are easy to perform and sensitive and allow for reproducible and quantitative results. As more isoenzymes and isoforms have been characterized, confusion has arisen due to the many different names they were given. For the sake of simplicity and because of structural analogies, we propose an alternative nomenclature for the ALP isoenzymes and isoforms based on their structural characteristics: soluble, dimeric (Sol), anchor-bearing (Anch), and membrane-bound (Mem) liver, bone, intestinal, and placental ALP. Together with lipoprotein-bound liver ALP and immunoglobulin-bound ALP, these names largely fit the many forms of ALP one can encounter in human serum and tissues. The clinically relevant isoenzymes are sol-liver, Mem-liver, lipoprotein-bound liver, and Sol-intestinal ALP in liver diseases, and Sol-bone and Anch-bone ALP in bone diseases. Many different isoenzyme patterns can be found in malignancies and renal diseases. This test provides the clinician with valuable information for diagnostic purposes as well as for follow-up of patients and monitoring of treatment. However, ALP isoenzyme determination will only provide clinically useful information if the patterns are correctly interpreted. In this respect, care should be taken to use the proper reference ranges, taking into account the age and sex of the patient. A normal total ALP activity does not rule out the presence of an abnormal isoenzyme pattern, particularly in children. Separating ALP into its isoenzymes adds considerable value to the mere assay of total ALP activity.
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Affiliation(s)
- V O Van Hoof
- Department of Clinical Chemistry, University Hospital Antwerp, Edegem/Antwerpen, Belgium
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Hirano K, Koyama I, Stigbrand T. Purification and partial characterization of the placental-like alkaline phosphatase in human lung tissue. Clin Chim Acta 1990; 186:265-73. [PMID: 2311255 DOI: 10.1016/0009-8981(90)90044-s] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- K Hirano
- Department of Pharmaceutics, Gifu Pharmaceutical University, Japan
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Fisken J, Leonard RC, Shaw G, Bowman A, Roulston JE. Serum placental-like alkaline phosphatase (PLAP): a novel combined enzyme linked immunoassay for monitoring ovarian cancer. J Clin Pathol 1989; 42:40-5. [PMID: 2921344 PMCID: PMC1141788 DOI: 10.1136/jcp.42.1.40] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A new combined enzyme linked immunoassay (ELISA) was developed to measure both serum placental-like alkaline phosphatase (PLAP) activity (PLAPA) and concentration (PLAPC) in the same microtitre plate using an Imperial Cancer Research Fund monoclonal antibody, designated H17E2. PLAP A and PLAP C were determined together with an existing marker, CA125 in 397 serial samples from 87 patients with epithelial ovarian cancer. Retrospective assessment showed the sensitivity to increase from 73% with CA125 alone, to 88% using CA125 and PLAP A, and to 93% with all three markers in 261 samples from the patients with known active disease at the time of sampling. When the results for all 397 samples were included in the analysis, however, the specificity, sensitivity, accuracy and predictive powers of this monoclonal antibody were not sufficiently high to assist in the prospective follow up of patients with ovarian cancer. This was due to a significant number of false positive and false negative results. Our data indicate that PLAP A or PLAP C estimation with H17E2 may, therefore, only be of value in the management of those patients with known active disease who are already known to be "marker positive" for this antigen.
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Affiliation(s)
- J Fisken
- University Department of Clinical Chemistry, Royal Infirmary, Edinburgh
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Ellard GA, Tucker DF, Pookim YL, Wang DY, Barlow RD, Stone RB. Serum placental-like alkaline phosphatase levels and nicotine intake in smokers. Br J Cancer 1988; 58:219-21. [PMID: 3166915 PMCID: PMC2246754 DOI: 10.1038/bjc.1988.198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- G A Ellard
- National Institute for Medical Research, Mill Hill, London, UK
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9
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Abstract
The changes in serum alkaline phosphatase that are of main diagnostic importance result from increased entry of enzyme into the circulation. This results from increased osteoblastic activity in bone disease, and increased synthesis of alkaline phosphatase by hepatocytes in hepatobiliary disease. The liver and bone forms of alkaline phosphatase are differently-glycosylated forms of a single gene product. The main value of their specific estimation is found in patients in whom bone and liver diseases co-exist, for example, as a result of cancer. Abnormal expression of genetically-distinct alkaline phosphatase isoenzymes is valuable in monitoring cancers, particularly germ-cell tumors. These isoenzymes include Regan and Nagao isoenzymes, which correspond respectively to normal placental and placental-like alkaline phosphatases, and the Kasahara isoenzyme which appears to result from re-expression of a fetal intestinal alkaline phosphatase gene.
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Affiliation(s)
- D W Moss
- Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K
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McLaughlin PJ, Warne PH, Hutchinson GE, Johnson PM, Tucker DF. Placental-type alkaline phosphatase in cervical neoplasia. Br J Cancer 1987; 55:197-201. [PMID: 3028462 PMCID: PMC2002092 DOI: 10.1038/bjc.1987.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Monoclonal antibodies reactive with placental-type alkaline phosphatase have formed the basis of methods for detection of this oncodevelopmental antigen in patients with pre-invasive and invasive cervical neoplasia, with or without evidence of papilloma virus infection. Disease-related elevations of placental-type alkaline phosphatase were not observed in patients' sera. Solubilised cervical smears or biopsy material, and cervical mucus swabs, often contained substantial amounts of this isoenzyme; however, there was no significant difference between any of the patient and control groups. Thus, serological and smear test assays for placental-type alkaline phosphatase were not useful in differential diagnosis of cervical lesions. However, its presence in most biopsy specimens, often at high levels, indicated possible application for in vivo radioimmunoimaging studies of invasive or metastatic cervical cancer.
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Moss DW. Multiple forms of acid and alkaline phosphatases: genetics, expression and tissue-specific modification. Clin Chim Acta 1986; 161:123-35. [PMID: 3542304 DOI: 10.1016/0009-8981(86)90206-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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