Plasma protein abnormalities in cancer

THE AGGLUTINATION OF TUMOUR CELLS IN VITRO BY SERA FROM TUMOUR PATIENTS AND PREGNANT WOMEN

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Biochemical and hematological tests in patients with breast carcinoma: correlations with extent of disease, sites of relapse, and prognosis

The value of serial biochemical and hematological tests of blood in differentiating stages and in detecting recurrence of breast carcinoma was studied in 500 patients. Patients who had mastectomy and were with no evidence of disease (NED group) had higher hemoglobin, albumin, total protein, and lower LDH than patients with any amount of breast carcinoma. These four tests became more abnormal in patients with metastatic disease (group IV). In addition, peripheral lymphocyte count was significantly decreased, and SGOT, AP, alpha-1 globulin, and CEA significantly increased, when patients developed recurrent or metastatic disease. Patients with disseminated soft tissue or lung metastasis had less abnormality of such blood tests than those with metastasis in bone or other visceras. Immunoglobulins (IgG, IgA, IgM) were not different between early or late stages, nor specific sites of metastatic involvement. Among patients with a greater amount of loco-regional disease (group III) and patients with metastatic disease (group IV), those who had hemoglobin greater than or equal to 12.5 gm%, lymphocyte count of 15-2,500/cmm, albumin greater than or equal to 4 gm%, AP less than or equal to 25 units, or LDH less than or equal to 400 units had significantly better 5-year survival rates.

Chemical and hematological screening in patients with malignant and non-malignant conditions

The value of multiphasic automated laboratory tests in differentiating stages of malignancy and in detecting recurrence of cancer was studied. Chemical SMA-12 tests (including calcium, phosphate, glucose, BUN, uric acid, cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase (AP), lactic dehydrogenase (LDH) and SGOT) and hematological SMA-4 tests (including hematocrit, hemoglobin, WBC and RBC counts) were performed in 1,578 patients. Baseline data obtained from 582 patients with benign, and 996 patients with malignant, lesions were subdivided according to age, sex, primary site, and extent of cancer. With advancing stages of cancer, there was a significant increase of AP and LDH, but decrease of albumin and hemoglobin. Among patients who had sequential tests, there was a significant decrease of uric acid and LDH with control of cancer, and increase of AP with development of distant dissemination.

Plasma sialyltransferase in patients with breast cancer

Sialyltransferase enzyme levels (Sialtx) CEA, and 10 standard laboratory tests were studied in 50 patients with treated, recurrent, or disseminated breast carcinoma. All groups of patients had elevated mean Sialtx activity (CPM/mg protein) as compared with normal controls. Sialtx levels (expressed as % of normal controls) of patients with disseminated lesions were significantly elevated as compared to patients without evidence of disease or with only soft tissue recurrences, whereas CEA and alkaline phosphatase levels were significantly elevated (peripheral blood lymphocyte count, total protein and albumin levels significantly decreased) in patients with recurrent disease of all sites. Among patients with disseminated breast cancer and normal CEA levels, about 50% had markedly elevated Sialtx activities. From our limited experience, it appears that Sialtx study is of value when CEA failed to indicate the presence of breast malignancy. Further testing including serial studies should be done to better define its clinical usefulness.

Quantitative change of serum protein and immunoglobulin in patients with solid cancers

There are many quantitative changes of serum protein and immunoglobulin fractions in patients with cancer of various sites, excluding those with leukemic and lymphoproliferative disorders. The commonest change in serum proteins of patients with neoplastic disease is a reduction in albumin concentration and elevation of alpha globulins, especially alpha-2 fraction. Immunoglobulins (IgG, A,M) are a heterogenous group of proteins contained in the gamma, beta, and alpha-2 electrophoretic fractions of serum proteins. The IgG was found to be significantly increased in patients with cancer of the skin and lung, but decreased in patients with cancer of the prostate and breast. Serum IgM was reported to be elevated in patients with sarcoma, melanoma, brain tumors, but decreased in patients with carcinoma of the ovary. Serum IgA was found to be elevated in patients with cancer of epithelial secretory organs, such as skin, breast, head and neck, lung, gut, prostate, and uterine cervix. Whether these findings reflect specific changes of the humoral arm of tumor-host interaction remains to be investigated.

Serum protein electrophoresis (SPE) and immunoglobulin levels in breast carcinoma

Serum protein electrophoresis (SPE) and immunoglobulin levels were studied in 50 patients with breast carcinoma before therapy (17 with stage I disease; 18 stage II; 15 stage III or IV), and in 55 patients after primary lesions were surgically removed and gave no evidence of recurrence. The most consistent and statistically significant abnormalities observed on SPE were those of albumin, globulin, and alpha-2 globulin. Patients who were free of disease during follow-up examinations had higher albumin and lower globulin and alpha-2 globulin levels than those with advanced breast cancer (P = 0.003, P = 0.03, and P = 0.001 respectively). There was no difference in concentrations of immunoglobulin G, A, or M among the 5 groups. Routine laboratory tests of hemoglobulin, lymphocyte count, calcium, alkaline phosphatase, creatinine phosphokinase, lactic dehydrogenase, and transaminase also did not differ among the groups, but carcinoembryonic antigen was significantly elevated in patients with stage III and IV disease.