Colin Walker

Acute‐phase reactant proteins and carcinoembryonic antigen in cancer of the colon and rectum

One hundred and twenty‐eight patients bearing primary malignancies of the large bowel were studied to ascertain the value of acute‐phase reactant proteins (serum protein hexose, ceruloplasmin, transferrin, alpha‐1‐antitrypsin, seromucoid and haptoglobin) either alone or in conjunction with carcinoembryonic antigen to accurately reflect the disease status of patients both before and after resection of their large bowel malignancy. The results indicate that acute‐phase reactant proteins have a higher diagnostic rate for the presence of malignancy than does CEA. Estimation of the serum protein hexose alone is of greater diagnostic value than a combination of acute‐phase reactant proteins. Furthermore, serum protein hexose and CEA are complementary and when combined will reflect the presence of malignancy in a greater number of patients than either one alone. Following resection of primary large bowel cancer, acute‐phase reactant proteins are as accurate as CEA in evaluating the disease‐free status of patients and furthermore when combined with CEA increased the predictive value for the detection of patients with recurrent disease. Cancer 52:154, 1983.

Serum glycoproteins in diagnosis and monitoring of patients with large-bowel cancer

The profile of serum glycoproteins is altered in malignancy with a relative increase in acute phase reactant proteins. A prospective study has been performed to investigate three sugar moieties (hexose, hexosamine and sialic acid) of these glycoproteins in the serum of large-bowel cancer patients as a possible guide to recurrence, and to compare these three variables with carcinoembryonic antigen (CEA). The three variables indicated the presence of colorectal cancer in over 65 per cent of 107 cancer-bearing subjects. Furthermore, the appearance of metastatic disease was associated with abnormalities in these variables in 10 of 11 patients, and appears more accurately reflected than with CEA. However, the three variables and CEA are cumulative in their value for predicting recurrent cancer. Monitoring of acute phase reactant proteins may therefore be of potential clinical benefit for monitoring of colorectal cancer patients at high risk of recurrence.

Tennessee antigen: The predictive value of preoperative and postoperative assays in large-bowel cancer

Twenty-nine of 31 patients bearing resectable colorectal cancers had elevated levels of serum Tennessee antigen in comparison with only eight of 31 patients for carcinoembryonic antigen. This high detection rate is, however, of limited value since the level of serum. Tennessee antigen is not specific for the presence of malignancy. There appeared to be no relationship between the level of preoperative serum Tennessee antigen and subsequent prognosis. Furthermore, in only nine of 31 patients did the serum Tennessee antigen level fall after removal of all macroscopic cancer. There also appeared to be no relationship between the level of serum TennaGen at three months after resection and subsequent prognosis. These findings are in contrast, to estimations of serum carcinoembryonic antigen.

Augmentation of Lymphocyte Surface Immunogenicity following Treatment with Dimethyl-Sulphoxide

A mixed leucocyte culture is an in vitro tool for assessing differences in cell surface antigenicity between two cell populations. The MLC technique has been used to assess alterations in immunogenicity of rat lymphocytes, when exposed to the agent dimethyl-sulphoxide. Using four different rat strains, DMSO has been shown to be a surface-active agent that significantly increases the immunogenicity of both splenic and peripheral blood rat lymphocytes, as assessed by an increase in MLC reactivity. No augmentation of MLC reactivity is seen when syngeneic lymphocytes are used in the culture system as both effector and stimulator lymphocytes, thus confirming the immunological nature of the enhancement seen in allogeneic cultures.

Peripheral blood lymphocyte levels in large-bowel cancer

The relationship between peripheral blood lymphocyte levels and monitoring and assessment of prognosis of patients with large-bowel cancer has been assessed. There does not appear to be a correlation between the absolute lymphocyte count and the state of disease. Furthermore, the preresection and postresection lymphocyte levels do not accurately predict the likelihood of recurrent cancer subsequently developing, and the serial monitoring of patients with peripheral blood lymphocyte levels adds no important new information to clinical follow-up.

Tennessee antigen: Its value in the monitoring of patients with colorectal cancer

Serial estimations of serum Tennessee antigen have been performed at regular three-month intervals on 35 patients with colorectal cancer who had undergone resection of all macroscopically obvious tumor but who were considered to be at high risk of developing subsequent metastases. The results were interpreted by a panel of surgeons in order to assess the clinical relevance of using serum Tennessee antigen for monitoring of patients. The serial estimation of serum Tennessee antigen was found to be very variable, difficult to interpret, and clinically unreliable as an accurate marker for the development of recurrent cancer in this group of patients. There are unacceptably high false-positive and false-negative diagnostic rates for serum Tennessee antigen estimations in comparison with serial estimations of carcinoembryonic antigen.