Role of fetal hemoglobin and placentral alkaline phosphatases in cancer patients

ABSTRACT

Fetal hemoglobin and the 3 placental alkaline phosphatases; kasahara, Nagao and Regan isoenyzymes were determined in 37 patients having primary carcinomas of various tissue origins and 7 cases having benign neoplasms together with 13 healthy individuals who served as controls. It was evident that patients with benign neoplasms had significantly increased levels of fetal hemoglobin [P < 0.05] and 2 of these patients expressed Regan isoenzyme. Concomitant elevation of both fetal proteins was not found in any of these patients. In patients with malignant diseases significantly increased levels [P < 0.001] of fetal hemoglobin were present. The highest levels and incidences were present in patients with GIT tumors. After radical resection of the tumor in 8 operable cases, fetal hemoglobin returned to normal levels in 5 cases and remained elevated in 3 cases. In cancer patients, positive expression of Kasahara isoenzyme was present in 16%, while positive expression of Regan isoenzyme was present in 20% and positive expressing of Nagao isoenzyme was present in 14%. Again patients with GIT tumors had the highest frequency [60%] of expression placental alkaline phosphatases. After complete resection of the tumor, complete disappearance of placental alkalikne phosphatases occurred. Patients with GIT tumors has the highest incidence of concomitant elevations of fetal hemoglobin and placental alkaline phosphatases. The reappearance of HbF in cancer patients could be attributed to triggering of erythropoiesis in the bone marrow or even the liver by the tumor derived nuclear proteins. The appearance of placental isoenzymes could be attributed t o the re-expression of the placental phosphatase gene. The overall concordance between the 2 proteins was found in 21 [57%] while the overall discordance was found in 16 [43%] of patients. These data indicate that the regulation of synthesis of these proteins is not under coordinate control