Soju Kurihara

Serum carcinoembryonic antigens in patients with carcinoma of the cervix.

Serum levels of carcinoembryonic antigen (CEA) were measured by a radioimmunoassay technique. The mean CEA level for 80 controls was 2.03 ng/ml with a standard deviation of 0.49 ng/ml. Hence, the upper limit of normal for serum CEA levels was considered to be 3.01 ng/ml, ie, two standard deviations above the mean. Serum CEA levels were measured in 86 patients with cervical squamous cell carcinoma, Stages 0 through IV. Thirty-five of the 74 patients with invasive cervical carcinoma were CEA-positive (serum levels above normal); patients with cervical dysplasia or carcinoma in situ were all CEA-negative. Study of the distribution of these patients together with the extent of their disease leads to the following conclusions: a) determination of serum CEA levels cannot serve as a test for the early diagnosis of cervical cancer or precancerous lesions; b) in patients with clinical Stage I or II cervical cancer, an elevated serum CEA level indicates a greater likelihood of parametrial invasion or lymph node metastasis; c) in patients with treated carcinoma of the cervix, continued normal levels of serum CEA affirm continued absence of the disease, whereas development of an elevated level is highly suspicious of occult residual or recurrent cancer. The authors urge periodic determinations of serum CEA levels in patients with treated cervical cancer.

Serum ferritin levels in patients with cervical cancer.

Serum ferritin levels were determined by a radioimmunoassay (a 2-site solid-phase method). The mean ferritin level for 52 control women was 35 ng/ml, and the 2nd to 98th percentile reference intervals were 3.9 to 108 ng/ml. The upper limit of ferritin level for controls was determined to be 108 ng/ml, and the sera from cervical cancer patients were screened. In 98 patients with untreated cervical cancer, 50 (51%) had elevated levels of serum ferritin. Among 36 patients who were surgically treated and whose resected specimens were pathologically examined, 12 of 16 patients (75%) with ferritin levels above normal and 3 of 20 patients (15%) with levels below 108 ng/ml had parametrial invasion and/or lymph node metastasis. Serum ferritin levels were measured at 2− to 4-week intervals and 6 months after treatment on 21 patients with levels elevated before therapy. Ferritin levels decreased to the normal range 4 weeks after treatment in many patients, but the development of elevated levels thereafter was closely associated with a poor prognosis. Measurement of serum ferritin may be useful in predicting the extent of cancer beyond the cervix and the prognosis for cervical cancer patients.

Heat-stable alkaline phosphatase in uterine cancer, with special reference to its histochemical heat-stability and the L-phenylalanine inhibition test

SummaryWe report a histochemical study of alkaline phosphatase (ALP) in normal cells of the female reproductive system, in pre-cancerous and cancerous lesions of the uterine cervix and in endometrial cancer to ascertain the incidence of ALP and its isoenzyme type. For this purpose, serial sections were subjected to heat stability andl-phenylalanine (LP) inhibition tests.The Regan-like isoenzyme, a heat-stable and LP-sensitive ALP, which has been thought to derive only from cancer or the placenta, was found in uterine cervical reserve cells and endometrial luminal surface lining cells. In contrast, ALP activity in endometrial glandular cells was found to be heat and LP sensitive.Of 183 cases of cervical neoplasia, 60 (33%) manifested non-specific ALP activity. One dysplasia and two invasive cancer cases manifested the Regan-like isoenzyme. The other 36 classifiable lesions had small-intestine ALP-like activity (marked heat and LP sensitivity) or a liver ALP-like isoenzyme (marked heat and slight LP sensitivity).Of 42 cases of endometrial cancer, all cases manifested non-specific ALP activity. Seven endometrial cancers exhibited the Regan-like isoenzyme. The other 19 cases manifested either small intestine of liver ALP-like isoenzyme.Our findings indicate that in the course of uterine carinogenesis, the ALP isoenzyme of reserve cell and endometrial glandular cells undergo a change and that enzyme deviation occurs.