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Zachou G, El-Khouly F, Dilley J. Evaluation of follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev 2023; 8:CD006119. [PMID: 37650760 PMCID: PMC10471005 DOI: 10.1002/14651858.cd006119.pub4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND This is an update of a previous Cochrane Review, last updated in 2014. Ovarian cancer is the eighth most common cancer and seventh most common cause of death due to cancer in women worldwide. Traditionally, most women who have been treated for cancer undergo long-term follow-up in secondary care. However, it has been suggested that the use of routine review may not be effective in improving survival, or health-related quality of life (HRQOL), or relieving anxiety. In addition, traditional follow-up may not be cost-effective. OBJECTIVES To compare the potential effects of different strategies of follow-up in women with epithelial ovarian cancer, following completion of primary treatment. SEARCH METHODS For this update, we searched the Cochrane Gynaecological Cancer Group Trials Register, CENTRAL 2022, Issue 11, MEDLINE, and Embase from August 2013 to November 2022. We also searched review articles and contacted experts in the field. SELECTION CRITERIA All randomised controlled trials (RCTs) that evaluated follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology. Two review authors independently selected potentially relevant trials, extracted data, and assessed risk of bias. They compared results, and resolved disagreements by discussion. We assessed the certainty of evidence, using the GRADE approach, for the outcomes of interest: overall survival (OS), health-related quality of life (HRQOL), psychological effects, and cost analysis. MAIN RESULTS For this update, we included one new RCT, including 112 women with ovarian, fallopian tube, or peritoneal cancer, who had completed primary treatment by surgery, with or without chemotherapy. This study reported the effect of individualised, i.e. individually tailored, nurse-led follow-up versus conventional medical follow-up on HRQOL, psychological outcomes, and cost-analysis. Individualised follow-up improved HRQOL in one of the two scales, with a decrease in mean difference (MD) in the QLQ-C30 discomfort scale following 12 months of individualised treatment compared to 12 months of conventional treatment (MD -5.76 points, 95% confidence interval (CI) -10.92 to -0.60; 1 study, 112 participants; low-certainty evidence; minimal important difference 4 to 10 points). There may be little or no difference in the other HRQOL scale (QLQ-Ov28, MD -0.97 points, 95% CI -2.57 to 0.63; 1 study, 112 participants: low-certainty evidence); psychological outcome, measured with the hospital anxiety and depression scale (HADS; MD 0.10 point, 95% CI -0.81 to 1.02; 1 study, 112 participants: low-certainty evidence), or cost analysis (MD -GBP 695.00, 95% CI -1467.23 to 77.23; 1 study, 112 participants: moderate-certainty evidence). Our previous review included one RCT, with 529 women in a confirmed remission, with normal CA125 concentration and no radiological evidence of disease, after surgery and first-line chemotherapy for ovarian cancer. This study evaluated immediate treatment of ovarian cancer relapse following a rise of serum CA125 levels versus delaying treatment until symptoms developed for OS, and HRQOL. There was little or no difference in OS between the immediate and delayed arms after a median follow-up of 56.9 months (unadjusted hazard ratio (HR) 0.98, 95% CI 0.80 to 1.20; 1 study, 529 participants; moderate-certainty evidence). Time from randomisation to first deterioration in global health score or death was shorter in the immediate treatment group than in the delayed treatment group (HR 0.71, 95% CI 0.58 to 0.88). AUTHORS' CONCLUSIONS Limited evidence from one trial suggests that routine surveillance with CA125 in asymptomatic women and treatment at CA125-defined relapse does not seem to offer survival advantage when compared to treatment at symptomatic relapse. However, this study pre-dates the use of PARPi maintenance treatment and the increased use of secondary cytoreductive surgery, so the results may be limited in their applicability to current practice. Limited evidence from one trial suggests that individualised nurse-led follow-up may improve HRQOL in women with ovarian cancer following completion of primary treatment. Large RCTs are needed to compare different types of follow-up, looking at survival, HRQOL, psychological effects, and cost as outcomes.
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Affiliation(s)
- Georgia Zachou
- Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Fatima El-Khouly
- Medical Oncology, Barking, Havering and Redbridge University Hospital NHS Trust, London, UK
| | - James Dilley
- Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London, UK
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Balbaied T, Moore E. Overview of Optical and Electrochemical Alkaline Phosphatase (ALP) Biosensors: Recent Approaches in Cells Culture Techniques. BIOSENSORS 2019; 9:E102. [PMID: 31450819 PMCID: PMC6784369 DOI: 10.3390/bios9030102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 12/12/2022]
Abstract
Alkaline phosphatase (ALP), which catalyzes the dephosphorylation process of proteins, nucleic acids, and small molecules, can be found in a variety of tissues (intestine, liver, bone, kidney, and placenta) of almost all living organisms. This enzyme has been extensively used as a biomarker in enzyme immunoassays and molecular biology. ALP is also one of the most commonly assayed enzymes in routine clinical practice. Due to its close relation to a variety of pathological processes, ALP's abnormal level is an important diagnostic biomarker of many human diseases, such as liver dysfunction, bone diseases, kidney acute injury, and cancer. Therefore, the development of convenient and reliable assay methods for monitoring ALP activity/level is extremely important and valuable, not only for clinical diagnoses but also in the area of biomedical research. This paper comprehensively reviews the strategies of optical and electrochemical detection of ALP and discusses the electrochemical techniques that have been addressed to make them suitable for ALP analysis in cell culture.
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Affiliation(s)
- Thanih Balbaied
- University College Cork, Sensing & Separation Group, School of Chemistry and life Science Interface, Tyndall National Institute, T12R5CP Cork, Ireland
| | - Eric Moore
- University College Cork, Sensing & Separation Group, School of Chemistry and life Science Interface, Tyndall National Institute, T12R5CP Cork, Ireland.
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Orsaria M, Londero AP, Marzinotto S, Di Loreto C, Marchesoni D, Mariuzzi L. Placental type alkaline phosphatase tissue expression in ovarian serous carcinoma. Cancer Biomark 2017; 17:479-486. [PMID: 27802199 DOI: 10.3233/cbm-160665] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To analyze the expression profile of placental type alkaline phosphatase (PLAP), cancer antigen 125 (CA125), and human epididymis protein 4 (HE4) in serous ovarian cancer and to correlate their expression with the tumor aggressiveness and progression. METHODS Retrospective study considering a tissue microarray of 82 women affected by ovarian serous cancer. Protein expression was assessed by immunohistochemistry on ovarian serous cancer tissue samples. Immunohistochemical staining was semiquantitatively evaluated as H-score. RESULTS Median H-score values were lower for PLAP, 1 (IQR 0-4) than CA125, 10 (IQR 6-12) or HE4, 8 (IQR 5-12). Even if PLAP was less expressed in the cells of serous ovarian cancer than CA125 or HE4 it was relatively more expressed in the fourth quartile of its H-score distribution among cases with low CA125 or HE4 expression. Furthermore, PLAP and HE4 high expression resulted to be significantly correlated with a better prognosis. CONCLUSIONS PLAP could be an additional marker for early detection of serous ovarian carcinoma, together with the established CA125 and HE4. In addition, PLAP expression is correlated with prognosis, giving, in this way, an additional tool for improving treatment approach.
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Affiliation(s)
- Maria Orsaria
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Ambrogio P Londero
- Unit of Obstetrics and Gynecology, Hospital of Monfalcone (GO), Italy.,Department of Experimental Clinical and Medical Science, DISM, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Carla Di Loreto
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Diego Marchesoni
- Department of Experimental Clinical and Medical Science, DISM, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
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Shi JX, Qin JJ, Ye H, Wang P, Wang KJ, Zhang JY. Tumor associated antigens or anti-TAA autoantibodies as biomarkers in the diagnosis of ovarian cancer: a systematic review with meta-analysis. Expert Rev Mol Diagn 2015; 15:829-52. [PMID: 25959246 DOI: 10.1586/14737159.2015.1035713] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jian-Xiang Shi
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
- 3Department of Biological Sciences, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
| | - Jie-Jie Qin
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Hua Ye
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Peng Wang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Kai-Juan Wang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Jian-Ying Zhang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
- 3Department of Biological Sciences, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
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Clarke T, Galaal K, Bryant A, Naik R. Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev 2014; 2014:CD006119. [PMID: 25198378 PMCID: PMC6457804 DOI: 10.1002/14651858.cd006119.pub3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Ovarian cancer is the sixth most common cancer and seventh commonest cause of death in women worldwide. Traditionally, many people who have been treated for cancer undergo long-term follow-up in secondary care. However, it has been suggested that the use of routine review may not be effective in improving survival, quality of life (QoL), or relieving anxiety, or both. In addition, traditional follow-up may not be cost-effective. OBJECTIVES To compare the potential benefits of different strategies of follow-up in patients with epithelial ovarian cancer following completion of primary treatment. SEARCH METHODS For this update we searched the Cochrane Gynaecological Cancer Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 7, 2013, MEDLINE and EMBASE from November 2010 to July 2013. We also searched reference lists of review articles and contacted experts in the field. SELECTION CRITERIA All relevant randomised controlled trials (RCTs) that evaluated follow-up strategies for women with epithelial ovarian cancer following completion of primary treatment. DATA COLLECTION AND ANALYSIS Two review authors independently abstracted data and assessed risk of bias. MAIN RESULTS The authors did not identify any new studies that were eligible for inclusion in this update of the review. The search for the original review identified only one RCT that met the inclusion criteria, which included 529 women. This study reported data on immediate treatment of ovarian cancer relapse following rise of serum CA125 levels versus delaying treatment until symptoms developed. All the women participating had previous confirmation of remission, with normal CA125 concentration and no radiological evidence of disease, after surgery and first-line chemotherapy for ovarian cancer.Overall survival between the immediate and delayed arms showed no difference after a median follow-up of 56.9 months (unadjusted hazard ratio (HR) 0.98, 95% confidence interval (CI) 0.80 to 1.20; P value 0.85). Time from randomisation to first deterioration in global health score or death was shorter in the immediate treatment group than in the delayed treatment group (HR 0.71, 95% CI 0.58 to 0.88; P value < 0.01). The trial was at low risk of bias. AUTHORS' CONCLUSIONS Limited evidence from a single trial suggests that routine surveillance with CA125 in asymptomatic patients and treatment at CA125 relapse does not seem to offer survival advantage when compared to treatment at symptomatic relapse. RCTs are needed to compare different types of follow-up, looking at survival, QoL, cost and psychological effects as outcomes.
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Affiliation(s)
- Tilean Clarke
- London Metropolitan University166‐220 Holloway RdLondonUKN7 8DB
| | - Khadra Galaal
- Princess Alexandra Wing, Royal Cornwall HospitalGynaecological OncologyTruroUKTR1 3LJ
| | - Andrew Bryant
- Newcastle UniversityInstitute of Health & SocietyMedical School New BuildRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Raj Naik
- Northern Gynaecological Oncology CentreGynaecological OncologyQueen Elizabeth HospitalGatesheadTyne and WearUKNE9 6SX
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Kew F, Galaal K, Bryant A, Naik R. Evaluation of follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. Cochrane Database Syst Rev 2011:CD006119. [PMID: 21678351 PMCID: PMC4171123 DOI: 10.1002/14651858.cd006119.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Ovarian cancer is the sixth most common cancer and seventh cause of cancer death in women worldwide. Traditionally, many patients who have been treated for cancer undergo long-term follow up in secondary care. Recently however it has been suggested that the use of routine review may not be effective in improving survival, quality of life (QoL), and relieving anxiety. In addition, it may not be cost effective. OBJECTIVES To compare the potential benefits of different strategies of follow up in women with epithelial ovarian cancer following completion of primary treatment. SEARCH STRATEGY We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010, Issue 4), MEDLINE and EMBASE (to November 2010). We also searched CINAHL, PsycLIT, registers of clinical trials, abstracts of scientific meetings, reference lists of review articles, and contacted experts in the field. SELECTION CRITERIA All relevant randomised controlled trials (RCTs) that evaluated follow-up strategies for patients with epithelial ovarian cancer following completion of primary treatment. DATA COLLECTION AND ANALYSIS Two review authors independently abstracted data and assessed risk of bias. MAIN RESULTS We found only one RCT (Rustin 2010) that met our inclusion criteria. This trial included 529 women and reported data on immediate treatment versus delayed treatment in women with confirmation of remission and with normal CA125 concentration and no radiological evidence of disease after surgery and first-line chemotherapy.Overall survival showed no significant difference between the immediate and delayed arms after a median follow up of 56.9 months (unadjusted hazard ratio (HR) = 0·98, 95% confidence interval (CI) 0·80 to 1·20; P = 0·85). Time from randomisation to first deterioration in global health score or death was significantly shorter in the early group compared with the delayed group (HR 0·71, 95% CI 0·58 to 0·88; P < 0·01). The trial was at low risk of bias. AUTHORS' CONCLUSIONS There is a lack of randomised studies on most aspects of follow-up care after treatment for epithelial ovarian cancers. Limited evidence from a single trial suggests that routine surveillance with CA125 in asymptomatic patients, with treatment at CA125 relapse, does not seem to offer survival advantage when compared to treatment at symptomatic relapse. Randomised controlled trials are needed to compare different types of follow up on the outcomes of survival, quality of Life, cost and psychological effects.
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Affiliation(s)
- Fiona Kew
- Gynaecological Oncology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Khadra Galaal
- Gynaecological Oncology, Northern Gynaecological Oncology Centre, Gateshead, UK
| | - Andrew Bryant
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Raj Naik
- Gynaecological Oncology, Northern Gynaecological Oncology Centre, Gateshead, UK
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7
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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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Alkaline phosphatase, cytokeratin 7, cytokeratin 8 in the diagnosis of primary lung adenocarcinoma from 148 pleura fluids specimens. Folia Histochem Cytobiol 2009; 47:87-92. [DOI: 10.2478/v10042-009-0001-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Torabi-Pour N, Nouri AM, Perrett D, Oliver RT. The combined use of high performance liquid chromatography and immuno-biochemical techniques for protein isolation: a new approach for identification of an individual protein from a pool of proteins. Biomed Chromatogr 2000; 14:483-8. [PMID: 11113929 DOI: 10.1002/1099-0801(200011)14:7<483::aid-bmc997>3.0.co;2-#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
HPLC was used in combination with immuno-bead separation technique for identification of an individual protein from a pool of proteins. This was carried out using an in-house monoclonal antibody (ATC2) specific for placental alkaline phosphatase (PLAP) as a primary antibody for conjugation to CNBr beads. The phosphatase activity (ALP) of PLAP was measured by colorimetric assay (MEDC). The data from this study has so far indicated that: 1. HPLC analysis of molecules following isolation with ATC2-conjugated beads showed high degree of purity. This could be achieved using protein mixtures prepared from lysates of tumour cell lines or tumour fragments. 2. HPLC-isolated PLAP maintained phosphatase activity. 3. Out of the four dissociation reagents used, diethyl amine (DEA) was found to be the best reagent for dissociation of antigen, ie PLAP, but not mAb from CNBr beads. 4. The profile of ALP activity was different for samples prepared from testis and kidney fragments, both in terms of the HPLC peak profile as well as the sensitivity. These data confirmed that the immuno-bead separation technique in conjunction with HPLC were powerful tools for identifying an individual protein from a pool of proteins. These approaches are being used for the identification of PLAP molecules, as a tumour marker in patients suspected of testicular malignancies with equivocal ultrasound.
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Affiliation(s)
- N Torabi-Pour
- Uro/Oncology Research and Analytical Biochemistry Unit, The Royal Hospital Trust, Whitechapel, London E1 1BB, UK
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Ben-Arie A, Hagay Z, Ben-Hur H, Open M, Dgani R. Elevated serum alkaline phosphatase may enable early diagnosis of ovarian cancer. Eur J Obstet Gynecol Reprod Biol 1999; 86:69-71. [PMID: 10471145 DOI: 10.1016/s0301-2115(99)00054-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A case of endometrioid ovarian carcinoma associated with elevated levels of serum placental-like alkaline phosphatase (PLAP) is presented. Two and a half years before a final diagnosis was made following explorative laparotomy, an incidental blood test revealed elevated alkaline phosphatase in the patient's serum. A thorough investigation for the source of this elevation was negative. Postoperative immunohistochemical staining of the tumor, showed diffuse stain with PLAP, along with gradual decline to normal values of serum total alkaline phosphatase. It is suggested, that whenever serum alkaline phosphatase is elevated due to unknown reason, an investigation including alkaline phosphatase isoenzymes, serum Ca-125, trans-vaginal pelvic sonogram and even diagnostic laparoscopy, should be considered in a search for early preclinical ovarian cancer.
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Affiliation(s)
- A Ben-Arie
- Department of Obstetrics and Gynecology, Kaplan Medical Center (affiliated to the Hebrew University and Hadassah, Jerusalem), Rehovot, Israel
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11
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Nakopoulou L, Stefanaki K, Janinis J, Mastrominas M. Immunohistochemical expression of placental alkaline phosphatase and vimentin in epithelial ovarian neoplasms. Acta Oncol 1995; 34:511-5. [PMID: 7605660 DOI: 10.3109/02841869509094016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The immunohistochemical expression of PLAP and vimentin was assessed in 23 benign, 6 borderline malignant and 31 malignant epithelial ovarian neoplasms. PLAP and vimentin were expressed in some benign (3/23 and 5/23 respectively) and borderline malignant (2/6 for both markers) tumours and they were often expressed in malignant tumours (16/31 and 17/31 respectively). There was a significantly increased expression of PLAP and vimentin in serous cystadenomas and serous carcinomas compared to their mucinous counterparts. Although there was no significant correlation between PLAP expression and histologic grade of carcinomas there was a trend towards increased expression in more differentiated carcinomas. No correlation was found between vimentin expression and degree of differentiation.
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Affiliation(s)
- L Nakopoulou
- Department of Pathology, University of Athens, Medical School, Greece
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12
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Ind TE, Iles RK, Carter PG, Lowe DG, Shepherd JH, Hudson CN, Chard T. Serum placental-type alkaline phosphatase activity in women with squamous and glandular malignancies of the reproductive tract. J Clin Pathol 1994; 47:1035-7. [PMID: 7829680 PMCID: PMC503069 DOI: 10.1136/jcp.47.11.1035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIM To investigate serum placental-type alkaline phosphatase (PLAP-type) activities in women with squamous and glandular malignancies of the reproductive tract using an immunoradiometric assay. METHODS PLAP-type immunoreactivity was measured in 180 women with non-ovarian malignancies of the reproductive tract and the values were compared with those from 334 controls. The cases comprised 18 vulval, nine vaginal, 103 cervical, 46 endometrial, and five fallopian tube cancers. RESULTS Serum PLAP-type activities were no different from controls in patients with squamous cell tumours. Women with adenocarcinoma of the cervix, endometrium, and fallopian tube had increased values: women with endometrial cancer had a median value nearly four times greater than that of controls. There was no direct correlation between PLAP-type activities and stage of disease in patients with endometrial cancer, but values reverted to normal after treatment. CONCLUSIONS Serum PLAP-type measurements are of no value in the management of patients with squamous cell tumours of the female reproductive tract. Raised activities can, however, be found in glandular tumours, in particular endometrial cancer where serum PLAP-type measurements may be of value in predicting remission.
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Affiliation(s)
- T E Ind
- Joint Academic Unit of Obstetrics, Gynaecology and Reproductive Physiology, St Bartholomew's Hospital, London
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Abstract
Radioimmunoscintigraphy (RIS) is a potentially valuable method for the detection of primary, secondary and recurrent malignant tumours. Antigens that have been used for monitoring as well as for RIS of ovarian carcinomas include CA 125, PLAP, HMFG, and CA 19-9. Between 70 and 100% of the tumours have been detected at RIS when these antigens have been used. Conventional methods, e.g., computerized tomography (CT) and ultrasonography (US), demonstrate similar or lower detection rate than RIS for tumour diagnosis. RIS gives additional information to conventional radiological methods (CT and US) for the detection of occult ovarian carcinomas. A review of earlier investigations is given and our own recent results using PLAP as a target antigen are presented. The future potential of the technology is discussed.
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Affiliation(s)
- K R Ahlström
- Department of Diagnostic Radiology, University of Umeå, Sweden
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Fergusson RJ, Fisken J, McIntyre MA, Roulston JE, Leonard RC. Measurement of placental alkaline phosphatase activity in benign and malignant pleural effusions. J Clin Pathol 1992; 45:1114-5. [PMID: 1479040 PMCID: PMC495009 DOI: 10.1136/jcp.45.12.1114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The usefulness of placental alkaline phosphatase (PLAP) as a diagnostic marker of malignancy was assessed in pleural fluid from 60 patients with effusions. Pleural fluid PLAP activities were measured by an enzyme linked immunoassay (ELISA) using the two monoclonal antibodies H17E2 and H317. Similar values were found in groups of patients with primary bronchial tumours (n = 12), secondary malignancies (n = 23), and "benign" conditions (n = 25). The highest values were found in a small subgroup of patients with metastatic ovarian carcinoma. However, the production of this enzyme by normal lung makes the measurement of PLAP in pleural fluid unhelpful as a diagnostic aid to distinguish "benign" from malignant effusions.
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Affiliation(s)
- R J Fergusson
- Department of Clinical Oncology, Western General Hospital, Edinburgh
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15
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Hamilton-Dutoit SJ, Lou H, Pallesen G. The expression of placental alkaline phosphatase (PLAP) and PLAP-like enzymes in normal and neoplastic human tissues. An immunohistological survey using monoclonal antibodies. APMIS 1990; 98:797-811. [PMID: 2171580 DOI: 10.1111/j.1699-0463.1990.tb05000.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The immunohistological expression of placental alkaline phosphatase (PLAP) and PLAP-like enzyme was studied in frozen sections from a wide variety (n = 254) of normal and malignant tissues using monoclonal antibodies reactive with PLAP (H317) and PLAP/PLAP-like enzyme (H17E2; H315). PLAP/PLAP-like reactivity was seen in normal thymus, and foetal and neonatal testis, and in 21 out of 22 malignant germ cell tumours (GCTs), but was also found in normal endocervix, normal Fallopian tube and in 28 out of 167 non-GCTs (particularly in ovarian and proximal gastrointestinal tract tumours). Positivity for true PLAP (as demonstrated with H317) was seen in term placenta, in endocervix, and in Fallopian tube (but not in other normal tissues) and was commonly found in ovarian and proximal gastrointestinal tract tumours. Reactivity with H317 was unusual in malignant GCTs (2 out of 22 cases). These findings confirm that PLAP/PLAP-like positivity is a highly sensitive immunohistological marker for malignant GCTs, but one which by itself is of only moderate specificity. Furthermore, expression of true PLAP is rare in GCTs and favours instead an origin from the ovary or proximal gastrointestinal tract. The results also indicate that the predominant heat-stable alkaline phosphatase species in normal foetal and neonatal testis, and in thymus has a similar immunohistological profile to that found in malignant GCTs, and is a PLAP-like enzyme ("germ cell alkaline phosphatase") distinct from true PLAP. The occurrence of this marker in GCTs would appear to reflect increased eutopic production of an enzyme present in trace amount in corresponding normal tissues rather than a genuine example of ectopic expression.
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Affiliation(s)
- S J Hamilton-Dutoit
- Laboratory of Immunohistology, University Institute of Pathology, Aarhus Kommunehospital, Denmark
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Nielsen OS, Munro AJ, Duncan W, Sturgeon J, Gospodarowicz MK, Jewett MA, Malkin A, Thomas GM. Is placental alkaline phosphatase (PLAP) a useful marker for seminoma? Eur J Cancer 1990; 26:1049-54. [PMID: 2148879 DOI: 10.1016/0277-5379(90)90049-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The usefulness of placental alkaline phosphatase (PLAP) as a tumour marker was assessed in 1578 serum samples from 236 patients with seminoma. Smoking habits were known for all but 7 patients (22 samples). Smoking was associated with significantly higher mean levels of PLAP in disease-free patients (28.8 [S.E. 2.1] U/l vs. 15.9 [1.3] U/l in non-smokers). Mean PLAP levels were higher in patients with active disease (78.6 [23.5] U/l in non-smokers and 47.2 [18.5] U/l in smokers). The median values showed a similar trend. However, there was considerable overlap between the various groups and differences between mean and median values indicated that PLAP values were distributed asymmetrically. The predictive value of PLAP as a tumour marker was consequently much less than superficial inspection of these values might suggest. In 97 patients on surveillance, only 2 out of 11 patients who relapsed had elevated PLAP at the time of clinically detectable relapse. With the upper limit of normal PLAP quoted by our laboratory (35 U/l), specificity and sensitivity were, respectively, 88% and 45% (all patients) and 96% and 47% (non-smokers). The sensitivity and specificity of PLAP were assessed in more detail for a series of threshold values (normal vs. abnormal) with a graphical method. Only in non-smokers did PLAP seem useful and even in this group the positive predictive value of an "abnormal" test may be low; less than 50% in clinically relevant circumstances. Serum PLAP assay cannot usefully stand alone as a marker for seminoma and its routine estimation contributes little to follow-up.
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Affiliation(s)
- O S Nielsen
- Department of Radiotherapy and Oncology, Radiumstationen, Aarhus, Denmark
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