ABSTRACT
PURPOSE: A sensitive, specific blood test to detect cancer would be of great value but the search for such a test has been fruitless so far. In actual practice, there is often a considerable interval between the point at which a tumor could have been detected and the point at which it produces symptoms as a result of tumor growth. The research has been largely directed toward the identification of tumor-specific subtances that are liberated into body fluid. These tumor markers will not only indicate the presence of a cancer but also identify its site of origin and morphology. The available tumor markers, including the oncofetal antigen, placental hormones and enzymes, do not have enough tumor specificity or sensitivity to be used in diagnosis, but they do have a selective role monitoring the progression of tumor growth and assessing the response to treatment. Plasma lipid abnormality occurs regularly in many experimental animal tumor system. In some cases, their pattern and pathogenesis as well as their correlation with tumor volume and histologic features have been well characterized. Since both in vivo and in vitro celluar lipid alterations have been studied most intensively and found most commonly in lymphoproliferative and myeloproliferative disease, these form a particularly interesting group of malignancies for further investigation. In this study, we prospectively evaluated 26 patients with leukemia and 10 patients with solid tumor with full plasma lipid profiles. METHODS: Plasma lipids and lipoproteins were studied in 36 patients with acute leukemia and solid tumor at initial presentation or relapse and lipid studies were regularly repeated during a period of clinical remission. Patients were admitted to the department of pediatrics Eulji general hospital between March 1988 and June 1992 and they had no drugs known to alter lipid metabolism. No patient had a history of thyroid disease or diabetes and none had evidence of hepatic or renal dysfunction. Full serum chemistry analysis was performed utilizing Automated Analyzer and total serum lactic acid dehydrogenase was used as an additional parameter of tumor burden in all patients. Lipoprotein concentrations in plasma were measured b electrophoresis, and total lipid, phospholipid and free fatty acid by enzyme immunoassay. RESULTS: A consistent and predictable pattern of alterations in plasma lipid and lipoproteins were found. This pattern consisted of a marked decrease in aloha-lipoprotein(p=0.0001) and total cholesterol(p=0.0066), and increase in beta-lipoprotein(p=0.0001). Changes in triglyceride, phospholipid, free fatty acid and pre-beta-lipoprotein levels were net significant. The degree of lipid abnormality was directly related to the underlying tumor burden in leukemia. Among the lipid and lipoprotein alteration, aloha-lipoprotein appeared to be most sensitive indicator for the presence of tumor. CONCLUSIONS: The result suggest that an abnormality in systemic lipid metabolism, possibly in cholesterol clearance, is present in cancer patient. There appeared to be a direct relationship between magnitude of lipid abnormality and the amount of tumor burden but at the present time the exact mechanism of tumor-host interaction and its possible clinical implications remain to be determined.