Antiserum against leukemia cell ferritin as a diagnostic tool for malignant neoplasms

Ferritin Immunohistochemical Localization in Normal and Neoplastic Colonic Mucosa

High levels of ferritin have been detected in serum and tumoral extracts of gastrointestinal neoplasms. However, its histological localization is not well known. An immunoperoxidase technique (PAP) was used for detecting ferritin in 30 colorectal carcinomas, 20 polyps and 8 cases of non-neoplastic mucosae. Ferritin staining was detected in stromal cells (98%) much more than in epithelial cells (21%). Connective cells were positive in 5 cases of normal mucosae (62%), 19 polyps (95%) and all carcinomas (100%). The number of positive cells gradually rose from normal mucosa to carcinoma with an intermediate score in adenomas. However, no relation could be found between the stromal ferritin score and dysplasia in polyps. Likewise, no relation was found between the stromal ferritin score and the differentiation grade, invasion or metastases in carcinomas. The positive epithelial pattern seen in 12 cases (21%) suggests non-specific staining due to passive diffusion from the stroma. Thus, these immunohistochemical findings suggest that in colonic neoplasms, ferritin could be a tumor marker produced mainly by stromal cell reaction more than by the epithelial cells.

The analysis of N-glycolylneuraminic acid(NeuGc) of hepatoma tissue and K562 cell ferritins using HPLC and mass spectrometry

Ferritin is an iron-storage protein and its serum level is known to increase in the patient of with inflammation and malignant tumor. To further elucidate the difference between ferritins from normal human liver tissue and that of cancer cells, their sialic acids were analyzed. The Western blot analysis and the cytochemical staining using anti-NeuGc antiserum indicated that ferritins from the human hepatocarcinoma tissue and malignant K562 cells contain NeuGc, but that from the normal liver does not. The result was also confirmed by HPLC analysis and MALDI-TOF/MS analysis of sialic acids which were derivatized by the DMB method. It was also shown that the sialic acid content in hepatocarcinoma ferritin was much higher than that in the normal liver ferritin. These results suggest that normal and cancerous liver ferritins are qualitatively and quantitatively different in sialylation. In addition, K562 cells were shown to express NeuGc even if the cells were cultured in serum-free media which lack NeuGc. This is of interest from the current concept that expression of NeuGc in human cells is due to uptake and utilization of exogenous NeuGc.

Clinical significance of serum iron and ferritin in patients with colorectal cancer

To clarify the significance of serum iron and ferritin as indicators of iron loss caused by continuous bleeding, and, thus, to determine their value as markers of colorectal cancer, values for the two were compared in male patients with early and advanced colorectal cancer and age-matched male controls. The mean value of serum iron levels in patients with advanced colorectal cancer was significantly decreased compared with values in patients with early colorectal cancer and controls, 50.5 +/- 38.6 micrograms/dl vs 93.0 +/- 32.1 micrograms/dl and 107.1 +/- 32.9 micrograms/dl, respectively (p < 0.001). The mean value of serum ferritin levels in patients with early and advanced colorectal cancer was also significantly decreased compared with controls, 80.5 +/- 35.0 ng/ml (p < 0.01) and 48.8 +/- 72.8 ng/ml (p < 0.001), respectively, vs 117.1 +/- 46.8 ng/ml. However, there was no significant difference between mean serum iron levels in patients with early colorectal cancer and controls. Eighteen (78.3%) of the 23 patients with advanced colorectal cancer and 3 (16.7%) of the 18 patients with early colorectal cancer had serum iron levels below 85 micrograms/dl and serum ferritin levels below 60 ng/ml. Levels of both serum iron and ferritin, without clinically evident anemia, are useful indicators of advanced colorectal cancer.

Placental isoferritin (PLF) in comparison with MCA and CEA in advanced breast cancer--first data from a pilot study

The development of new and effective marker substances has optimized tumor-marker-guided follow-up programs to monitor generalization of disease and to assess the therapeutic outcome. Isoferritins of placental origin were first determined in the serum of patients with lymphoproliferative disease by way of the recently developed monoclonal antibody CMH-9. We have set up an Austro-Israeli working group and analysed 64 patients in terms of the sensitivity of placental ferritin (PLF) compared with the standard markers carcinoembryonic antigen (CEA) and mucinous-like cancer-associated antigen (MCA) in patients with metastatic breast cancer. We have additionally evaluated the importance of combined marker determination. Analysis of the data in view of site of metastatic spread yielded satisfying results both for PLF (sensitivity 70.4%) as well as MCA (sensitivity 76.9%) for visceral metastases; a combination of these two markers revealed a striking sensitivity of 88.4%, which, however, could not be improved by adding the third marker (CEA). With regard to non-visceral metastases, CEA and MCA were clearly superior.

Tumor marker radioimmunoassays in gastric juice. Methodologic drawbacks due to pH variations

Conflicting data have been reported on tumor marker determination in gastric juice. In the present study the effect of pH variations on both antibody-antigen binding and the immunologic stability of the antigen were evaluated for the radioimmunoassay of carcinoembryonic antigen, CA19-9, tissue polypeptide antigen, and ferritin. A significant inhibition of antibody-antigen binding was constantly found in acidic conditions. Antigen concentration was lower in acidified than in untreated samples, possibly due to the carryover of acidity in the incubation mixture. Neutralization of acidified samples partly improved recovery of carcinoembryonic antigen and CA19-9. Tissue polypeptide antigen and ferritin were not recovered by neutralization in samples with pH less than 4.5, suggesting an irreversible damage of the immunologic characteristics of the two antigens. From the present data we conclude that an accurate validation of methods and a rigorous standardization of sample collection are mandatory for tumor marker determination by radioimmunoassay in gastric juice.

Iron, ferritin, hepatitis B surface and core antigens in the livers of Chinese patients with hepatocellular carcinoma

Surgically resected specimens, consisting of tumor and adjacent non-neoplastic liver tissue, were obtained from 40 patients with primary liver cancer at Zhong Shan Hospital, Shanghai Medical University, the People's Republic of China, between March 1983 and July 1984. All were hepatocellular carcinomas (HCC), one being admixed with cholangiocarcinoma. The relationship of hepatitis B virus (HBV) markers with iron and ferritin was evaluated in liver tissues from patients with primary liver cancers. The serum HBsAg (Hepatitis B surface antigen) positive rate was 80.0% (32/40). Cirrhosis was observed in 97.5% (39/40). HBsAg was identified in 82.5% (33/40) of uninvolved liver, and 35.0% (14/40) of HCC tissues (P less than 0.001). HBcAg (hepatitis B core antigen) was detected in 25.0% (10/40) of liver, and 7.5% (3/40) of HCC tissues (P less than 0.05). Stainable iron was found in 65.0% (26/40) of unaffected livers, and 10.0% (4/40) of HCC tissues (P less than 0.001). Ferritin was demonstrated in 75% (30/40) of non-neoplastic liver, and 40% (16/40) of HCC tissues (P less than 0.001). Twenty-two of 33 HCC patients (66.7%) with HBsAg positive cells in their livers also showed stainable iron. Of 16 patients positive for ferritin in HCC cells, iron was found in only two. Iron was found in nine of ten patients with HBcAg in non-neoplastic hepatocytes (P = 0.056); a finding compatible with the hypothesis that iron accumulates in cells replicating HBV. The other results indicate that: immunohistologic ferritin in HCC is not due to increased stainable iron; tumor cells may produce ferritin; polyclonal antibodies to human liver ferritin react better with non-neoplastic hepatocytes than with HCC cells; the high prevalence of HBsAg and cirrhosis in HCC suggests that HBV plays a major etiologic role in hepatocarcinogenesis in China; and one case of HCC is attributed to Schistosoma japonicum infestation via cirrhosis.

Immunohistochemical ferritin in testicular seminoma

Immunohistochemical ferritin was demonstrated in all 23 (100%) testicular seminomas studied with antisera to liver ferritin (largely of basic isoferritins) and to myocardial ferritin (containing more acidic isoferritins). With liver ferritin antibody immuno-stain was strong in 74% with a diffuse distribution in 41%. The remaining six tumors showed moderate immuno-stain, of diffuse distribution in two. The myocardial ferritin antibody showed the following: strong immuno-stain in 52%, 58% of diffuse distribution; and moderate immuno-stain in 30%, 86% of focal distribution. Although ferritin is widespread in nature, the facts that both basic and acidic isoferritins are present in the majority of testicular seminomas, and that serum ferritin levels are reported to be increased in over 80% of patients with seminoma suggest that the demonstration of raised serum ferritin levels in the face of negative or low serum assays for human chorionic gonadotrophin and alpha-fetoprotein possibly may prove to be useful in the diagnosis, and evaluation of extent and recurrence of testicular seminomas.

Immunohistochemical ferritin in hepatocellular carcinoma

Serum ferritin concentrations are elevated in 35% to 100% of patients with hepatocellular carcinoma (HCC). With an immunoperoxidase technique, ferritin was demonstrated in tumor tissue from 32 of 74 (43%) black southern African patients, and from 12 of 19 (63%) American patients with HCC (P greater than 0.1). Ferritin was present in nonneoplastic liver in 82% of African and 100% of American patients (P greater than 0.1). Moderate to large amounts of stainable hepatic storage iron (hemosiderin) were present in 76% of African and 67% of American patients (P greater than 0.1). Fifty-two (70%) African patients had macronodular cirrhosis. In the literature, 80% to 90% of American patients with HCC have cirrhosis. High serum ferritin levels in patients with HCC may be due to ferritin production by the tumor, or related to the associated iron overload and/or cirrhosis.

Possibly unique subunit(s) of human ferritins responsible for tissue specificity

The biochemical characteristics of human placental and hepatic ferritins were compared. By DEAE cellulose column chromatography, placental ferritin was found to contain more acidic isoferritins, while hepatic ferritin was richer in basic isoferritins. The electrofocusing patterns of subunits revealed that placental ferritin contained at least one unique subunit on the acidic side and might lack one subunit on the basic side as compared with hepatic ferritin. It is hypothesized that microheterogeneities, immunological as well as biochemical, existing between placental and hepatic ferritins cannot be explained merely in terms of different proportions of known acidic and basic subunits, but appear to have resulted from the existence of the unique acidic subunit of placental ferritin and possibly also a unique basic subunit of hepatic ferritin.

Serum ferritin in hepatocellular carcinoma. A comparison with alphafetoprotein

The serum ferritin level was raised in 34 of 35 (97%) patients with hepatocellular carcinoma and in 20 of 23 (87%) with uncomplicated cirrhosis. Levels rose following therapeutic embolisation in 14 of 15 patients and continued to rise in 85% of all tumor patients who showed no clinical response to chemotherapy (intravenous Adriamycin) whereas in those who did respond the serum ferritin level fell. By contrast, there was a fall in serum alphafetoprotein immediately after embolisation but like serum ferritin, alphafetoprotein levels rose with disease progression and only fell in those achieving clinical remission. Serum ferritin has no role in the differential diagnosis of hepatocellular carcinoma but may be a useful marker in monitoring response to chemotherapy particularly in the alphafetoprotein-negative patient.

Acute monocytic leukemia cell isoferritin

Ferritin was purified from acute monocytic leukemia cells, and its biochemical and immunological properties were investigated. The iron content of acute monocytic leukemia cell ferritin was extremely low, and this ferritin migrated slightly faster than normal adult liver ferritin on immunoelectrophoresis and polyacrylamide gel disc electrophoresis. Isoelectric focusing in polyacrylamide gel showed predominantly acidic isoferritins. This was considered to characterize the nature of isoferritin from normal monocytes or to be the result of neoplastic change of monocytes. Immunologic studies failed to recognized any antigenic differences between isoferritin from acute monocytic leukemia cells and that from normal adult liver. Therefore, selective quantitation of acute monocytic leukemia cell isoferritin, if any in leukemic sera, by means of immunoassay was considered difficult.

A biochemical comparison of normal human liver and hepatocellular carcinoma ferritins

1. The iron contents, gel migration rates and isoelectric-focusing patterns of normal liver and hepatocellular carcinoma ferritins from the same patients were compared. 2. Sucrose-density-gradient centrifugation showed that the number of iron atoms per ferritin molecule was decreased to approximately half in carcinoma tissue when compared with normal liver. 3. On electrophoresis, hepatocellular carcinoma ferritin migrates faster and is therefore more negatively charged than normal liver ferritin, thus refuting the general view that the more negatively charged a ferritin molecule the greater its iron content. 4. Comparison of tumour and normal liver ferritin subunit compositions on acid/urea/polyacrylamide gels showed hepatocellular carcinoma ferritin to contain an additional, more negatively charged, subunit to normal liver ferritin. 5. Isoelectric focusing showed that hepatocellular carcinoma tissue contains isoferritins with isoelectric points intermediate between the ranges of normal liver and normal heart isoferritins.

Serum ferritin

(1) Brief introduction to iron metabolism and the biochemistry of ferritin. (2) Early studies of circulating ferritin. (3) Methods for measuring serum ferritin concentrations -- immunoradiometric, radioimmuno- and enzyme-linked immuno assays based on liver or spleen ferritin -- an evaluation of these techniques. (4) Serum ferritin concentrations in normal subjects -- definition of normality -- relationship between storage iron and serum ferritin concentrations -- changes during development from birth to old age -- iron deficiency -- variability of serum ferritin concentration -- evaluation of use of ferritin assay for assessment of storage iron levels. (5) Serum ferritin concentrations in disease -- hemochromatosis -- secondary iron overload -- liver damage -- infection and chronic disease -- cancer. (6) Assay of serum ferritin with antibodies to ferritins other than liver or spleen -- ferritinemia and cancer. (7) Properties of serum ferritin -- molecular weight -- iron content -- isoelectric focusing patterns -- carbohydrate content -- immunological properties. (8) Physiology of circulating ferritin -- release of ferritin from tissues -- origin of circulating ferritin -- clearance from the plasma -- iron and protein turnover. (9) Summary -- factors influencing serum ferritin concentrations and clinical use of ferritin estimations.

Serum ferritin assay

Ferritin is an iron storage protein of high-molecular weight which is primarily present in the liver, spleen, and bone marrow. A very sensitive immunoradiometric assay has been developed which permits determination of serum concentrations in normal persons and in patients with a variety of different disorders. In normal subjects, the serum ferritin concentration correlates very well with total body iron stores as measured by phlebotomy. The serum ferritin concentration is reduced in patients with iron-deficient anemia and is significantly higher in patients who are anemic for other reasons. Subject areas discussed in this review include the details of the immunoradiometric procedure, the sensitivity and accuracy of the assay, factors influencing the assay, values characteristic of a variety of clinical disorders, and the utility of the assay in clinical medicine and public health.

A comparison of various agarose preparations in a counter--immunoelectrophoresis (CIE) system for assaying urinary myoglobin

Twenty-two samples of commercial agarose were utilized as the gel matrix in a counter-immunoelectrophoresis (CIE) for detection of urinary myoglobin. When different samples were tested under identical conditions, significant differences in the detectable levels of myoglobin by CIE could be traced to the quality of the agarose used. The quality of agarose preparation could be improved by repurification using polyethylene glycol precipitation. The necessity of using purified agarose when assaying for urinary myoglobin by CIE is stressed. This is particularly important when the test is used in the early detection of myocardial infarcts.

Ferritin phenotypes: structure and metabolism

Recent advances in our understanding of the biochemistry of ferritin have provided new insights into its role in iron metabolism. Findings of multiple structural forms in many tissues may have important consequences for ferritin's function and metabolism. This article reviews the molecular basis of apoferritin heterogeneity and discusses mechanisms operating in the phenotypic expression of ferritin in normal and malignant cells.