Bone marrow acid phosphatase in prostate cancer: an assessment by immunoassay and biochemical methods.

Comparisons of the bone marrow and serum acid phosphatase values obtained by counter-immunelectrophoresis and the Roy biochemical test were made in 72 patients with and in 13 patients without prostatic cancer. The counter-immunoelectophoresis test, when positive at more than 1 international unit per liter, showed only 4.4 per cent falsely positive results. The Roy biochemical test, which used sodium thymolphthalein monophosphate as the substrate, had 65 per cent falsely positive bone marrow acid phosphatase levels. Conflicting reports regarding the value of bone marrow acid phosphatase determinations in patients with prostatic cancer result from the use of non-specific substrates in biochemical methods for measurement and from the trauma incidental to bone marrow aspiration, which releases many non-prostatic acid phosphatase enzymes. The use of immunoassay such as counter-immunoelectrophoresis minimizes this source of error.

Bone marrow acid phosphatase in prostate cancer: an assessment by immunoassay and biochemical methods.

Comparisons of the bone marrow and serum acid phosphatase values obtained by counterimmunoelectrophoresis and the Roy biochemical test were made in 72 patients with and in 13 patients without prostatic cancer. The counter-immunoelectrophoresis test, when positive at more than 1 international unit per liter, showed only 4.4% falsely positive results. The Roy biochemical test, which uses sodium thymolphthalein monophosphate as the substrate, had 65% falsely positive bone marrow acid phosphatase levels. Conflicting reports regarding the value of bone marrow acid phosphatase determinations in patients with prostatic cancer result from the use of non-specific substrates in biochemical methods for measurement and from the trauma incidental to bone marrow aspiration, which releases many non-prostatic acid phosphatase enzymes. The use of immunoassay such as counter-immunoelectrophoresis minimizes this source of error.

An animal model for the study of prostatic adenocarcinoma.

After the injection of the potent carcinogen 9,10-dimethyl-1,2-benzanthracene (DMBA) male rats (Fisher/Furth), mice (Strong A/J), and Golden hamsters, which had been previously conditioned by castration and in which the prostate had become histologically atrophic, developed tumors consistent with prostatic adenocarcinoma. One month after castration, intravenous injections of DMBA were given in the vena cava or jugular vein once a month for 3 months. Three to four months later, histologic evidence of prostate adenocarcinoma was consistently found in each of the groups of castrated animals (11 rats, 22 mice, and 11 hamsters) which survived the experiment. The glands were enlarged grossly and ureteral obstructions were also noted. Metastasis to the lung also occurred in five mice, three rats, and one hamster.

Radical retropubic prostatectomy for cancer: a 20-year experience.

A review of 159 patients treated by radical retropubic prostatovesiculectomy from 1951 through 1970 has reinforced our belief that this is a satisfactory method of treatment for prostatic cancer confined to the prostate. A 10-year survival of 55 per cent and a 15-year survival of 45 per cent compare well to the results reported for perineal prostatectomy. The postoperative mortality rate was 2.5 per cent and total incontinence was 12.5 per cent after radical retropubic prostatectomy. Completely normal voiding occurred in 108 of the 159 patients. Stress incontinence but no need for an incontinence device occurred in 31 patients. Improved methods for preoperative staging of the disease give promise for even higher cure rates in the future.

Microscopic foci of cancer in prostatectomy for benign disease: diagnostic and surgical considerations.

A study of 66 patients in whom microscopic foci of prostatic cancer was found in prostatectomies done for benign prostatic hyperplasia revealed in 32 of the 66 cases (48%) that there were in retrospect abnormal rectal findings that should have suggested the possibility of neoplasia. Other abnormalities were elevated serum acid phosphatase (5 patients), asymmetrical enlargement of one lateral prostatic lobe at cystoscopy (7 patients), and unilateral hydroureteronephrosis (7 patients). Urinary retention was the presenting symptoms in 56% of the patients. Difficult enucleation was noted in 41% of the open prostatectomies. The importance of performing careful prostatic biopsy in any suspicious prostatic enlargement is again stressed.

Bone marrow acid phosphatase: prognostic value in patients undergoing radical prostatectomy.

Preoperative bone marrow acid phosphatase determinations were elevated in 18 of 31 patients who underwent radical prostatectomies. A review of the surgical pathology and clinical followup demonstrated a higher incidence of metastasis in these patients.

Anergy and tryptophan metabolism in bladder cancer.

The tryptophan loading test and cutaneous antigen test were done on 55 patients with various stages of bladder cancer. Patients with an abnormality of tryptophan metabolism showed a greater degree of unreactivity to cutaneous delayed hypersensitivity testing. Of the 23 patients with normal tryptophan metabolism 47 per cent were unreactive to 2 or 3 skin antigens. Of 13 patients with 1 abnormal tryptophan metabolite 62 per cent were unreactive to 2 or 3 skin antigens. Of 19 patients with 2 or more abnormal tryptophan metabolites 68 per cent were unreactive to 2 or 3 antigens.

A new method for determination of urinary tryptophan metabolites in bladder carcinoma.

Abnormal tryptophan metabolism in patients with bladder carcinoma has been reported to have an extremely high correlation with future tumor recurrences. The methods for determination of these urinary metabolites have not been applicable for routine clinical use in the past. A new method is described using thin layer chromatography followed by fluorescent scanning with the SD 3000 spectrodensitometer. The range of recovery for the 6 tryptophan metabolites was from 96.9 to 106.7 per cent. In our study 31 per cent of the male and 50 per cent of the female bladder cancer patients had 2 or more abnormal tryptophan metabolites.

Observations on possible autoimmune therapeutic effects in experimentally produced rat bladder tumors.

Autoimmune response to normal and tumor bladder tissues in Fisher/Furth rats were obtained. The reaction consisted mainly of severe pericystitis and hemorrhagic lesions. The cellular infiltrate was predominantly lymphocytic including also plasma cells and histiocytes. Serological tests indicated development of host immunological response. 15 of 33 rat bladder tumors involuted entirely in the course of the autoimmune reaction.