Clinical evaluation of serum gamma-seminoprotein in patients with prostatic cancer

The level of serum gamma-seminoprotein (gamma-Sm) was measured by enzyme immunoassay in 62 patients with untreated prostatic cancer and 89 patients with benign prostatic hypertrophy histologically diagnosed to assess the clinical usefulness as a tumor marker. The level of serum prostatic acid phosphatase (PAP) was also measured by radioimmunoassay in these patients simultaneously. Serum gamma-Sm levels in prostatic cancer were significantly higher than in benign prostatic hypertrophy. There was a tendency for serum gamma-Sm levels in prostatic cancer to increase with statistically significant difference as the stage progressed. A gamma-Sm level of over 5.0 ng/ml was considered to be positive. The positive rate of gamma-Sm was 56.5% in prostatic cancer (stage A.B: 32.3%, stage C: 75.0%, stage D: 90.9%) and 19.1% in benign prostatic hypertrophy. In stage A.B cases, the positive rate of gamma-Sm was higher than that of PAP. Therefore, the measurement of gamma-Sm is considered to be useful in the diagnosis of early prostatic cancer.     

Clinical evaluation of gamma-seminoprotein as a serum marker of prostate carcinoma

The serum levels of gamma-Seminoprotein (gamma-Sm) were determined by enzyme immunoassay in 77 patients with prostatic cancer (30 untreated and 47 treated), 44 patients with benign prostatic hypertrophy and 12 patients with prostatitis. Serum levels of gamma-Sm in each disease were as follows; untreated prostatic cancer 23.2 +/- 18.3 ng/ml (positive rate 93%), treated prostatic cancer 4.7 +/- 8.3 (positive rate 25.5%), benign prostatic hypertrophy 3.6 +/- 3.3 (positive rate 23.7%), prostatitis 2.0 +/- 2.0 (positive rate 7.7%). Serum gamma-Sm levels in prostatic cancer were higher in advanced stage but relatively low in poorly differentiated adenocarcinoma. We consider that the level of serum gamma-Sm is a useful tumor marker as well as prostatic acid phosphatase (PAP) in diagnosis and follow-up of the patients with prostatic cancer.     

The significance of serum gamma-seminoprotein in prostatic cancer

The level of serum gamma-seminoprotein (gamma-Sm) was determined by enzyme immunoassay using an EIA gamma-Sm test kit in 32 patients with prostatic cancer (before treatment for 12 and after treatment was started for 20), 24 patients with benign prostate hypertrophy and 22 patients with other urogenital cancer. A gamma-Sm level of over 4.0 ng/ml was considered to be positive. The positive rate was 43.8% in prostatic cancer patients (83.3% before and 20.0% after treatment), 25.0% in benign prostate hypertrophy and 0% in other urogenital cancer. Since the positive rate of prostatic acid phosphatase (PAP) was 34.3% in prostatic cancer patients (75.0% before and 10.0% after treatment) and 16.7% in benign prostate hypertrophy patients, gamma-Sm may be more sensitive but less specific as an indicator of prostatic cancer in PAP. In 9 patients with prostatic cancer before treatment, the levels of serum gamma-Sm and PAP were serially determined for up to 11 months. The level of gamma-Sm decreased in 7 patients, and PAP in all patients after hormone therapy. One patient showed a consistently positive gamma-Sm level and the level of the others became positive only for gamma-Sm during follow-up. There was a statistical correlation between the levels of serum gamma-Sm and PAP in patients with prostatic cancer (r = 0.595, p less than 0.01), in patients with benign prostate hypertrophy (r = 0.882, p less than 0.01) and also in the patients in both groups together (r = 0.590, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Role of gamma-seminoprotein (gamma-SM) and prostatic acid phosphatase (PAP) as tumor markers of prostatic cancer

Between June, 1986 and December, 1987, the serum gamma-Sm and PAP was measured in 29 men with untreated prostatic cancer, 45 with treated prostatic cancer (32 were well-controlled and 13 poorly controlled), 82 with benign prostatic hypertrophy and 10 with other urological diseases. All of the patients with prostatic cancer had histologically proven disease. Enzyme immunoassay for gamma-Sm and radioimmunoassay for PAP were used. The cut-off value for gamma-Sm was 4 ng/ml and that for PAP was 3 ng/ml. The mean values of gamma-Sm and PAP were statistically high in the untreated group and also in poorly-controlled group. In the untreated group, the rate of positivity for gamma-Sm and for PAP were 69% respectively and 83% of the patients had elevated values for either or both of these markers. In clinical stage A and B, gamma-Sm and PAP values were within the normal limit, however the concentrations of mean gamma-Sm and PAP correlated well with the stage of disease. In the poorly-controlled group, positive gamma-Sm values were detected in 75% and PAP in 67%, whereas almost all of the patients had normal values for these markers in the well-controlled group. In prostatic hypertrophy, elevated gamma-Sm values were detected in 15% and elevated PAP values in 6%. After the onset of treatment, elevated values were normalized in 66.7% of the patients for gamma-Sm and in 68.4% for PAP. In the untreated group, gamma-Sm tended to show a more prompt response. In the ill-controlled group, gamma-Sm and PAP returned to normal in 50% of the patients. gamma-Sm and PAP values were well correlated with the course of the prostatic cancer and the clinical usefulness became more obvious with a combination of these markers.     

Clinical significance of tumor markers in prostatic carcinoma--comparative study of prostatic acid phosphatase, prostate specific antigen and gamma-seminoprotein

We measured the prostatic acid phosphatase (PAP), gamma-Seminoprotein (gamma-Sm) and prostate specific antigen (PA) in the serum of 862 patients with various urologic diseases including 89 patients with prostatic cancer. We used a PAP radioimmunoassay kit, gamma-Sm enzyme immunoassay kit, Markit-F-PA enzyme immunoassay kit and PA test Wako enzyme immunoassay kit. Serum PA level in advanced prostatic carcinoma (stage C, D) tended to be higher than that in early stage cancer (stage A, B). The Wako kit gave a higher PA than the Markit-F in each stage. The sensitivity rate of Wako PA test was the highest (81%) of all kits. The specificity rate of PAP was the highest (83%), and the accuracy rate of Markit-F PA was the highest (79%). The positive rate in the combined assay of PAP, gamma-Sm and PA in prostatic cancer was higher than that in the single assay of each tumor marker. We regarded PAP, gamma-Sm and PA as clinically different tumor markers, because their serum level did not correlate definitely. No apparent correlation was found between histopathological grade and the level of each tumor marker. The level of PAP, gamma-Sm and PA in the reactivated patients was significantly higher than that of the well-controlled patients. In the reactivated patients, the positive rate of Markit-F PA was the highest (89%) of all the kits.     

Prostate specific antigen in serum of the patients with prostatic cancer

The serum prostate specific antigen (PA) was determined with the Diagnostic Products Cooperation (DPC) PSA double antibody radioimmunoassay kit. The upper limit of the normal range was set at 4 ng/ml which was the mean + 3S.D. for males over 50 years old in a mass examination. For comparison, prostatic acid phosphatase (PAP), and gamma-seminoprotein (gamma-Sm) were determined using an Eiken kit and Chugai kit, and PA was also assayed using another kit (Eiken, Travenol). Positive rate of PA and PAP in the untreated prostatic cancer was 75 and 33% in Stage A, 100 and 0% in Stage B, 100 and 100% in Stage C, 100 and 67% in Stage D1, 100 and 80% in Stage D2 and 73 and 33% in benign prostatic hypertrophy (BPH), respectively. The level of PA determined during the follow-up of prostatic cancer showed the usefulness of simultaneous PA and PAP assays for monitoring the clinical course. The PA level using a DPC kit was highly correlated to that of PA using other kit, but the correlation with gamma-Sm and PAP was low. These results show that the DPC kit is useful for determining PA, and determination of PA and PAP is of great value both in diagnosis and in the follow-up of prostatic cancer, but the high positive rate in BPH remains a problem.     

Prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PA) in prostatic cancer

The levels of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PA) were determined in the serum of 200 untreated patients 28 patients with reactivated prostatic cancer and 179 patients with benign prostatic hypertrophy (BPH) from 1979 to 1987. PAP and gamma-Sm were determined using an Eiken and Chugai kit, respectively and PA was assayed using an Eiken or Travenol kit. The sensitivity of PAP, gamma-Sm and PA respectively in the untreated prostatic cancer cases was 0, 0% and 67%, for Stage A1, 25, 17 and 100% for Stage A2, 23, 50 and 60% for Stage B, 62, 81 and 94% in Stage C, 58, 67 and 90% for Stage D1, 86, 88 and 100% for Stage D2. The specificity of PAP, gamma-Sm and PA is 89, 69 and 43%, respectively. The efficiency of PAP was the highest at all stages as a whole, but when compared at each stage, gamma-Sm was the highest at Stages B and C. The sensitivity of simultaneous assays of PAP and gamma-Sm was slightly increased, but sensitivity was not increased by simultaneous use of three markers. The efficiency of a simultaneous assay was lower than that of a single assay with PAP. However, combined determination of gamma-Sm or PA with PAP was found to be useful for monitoring the clinical course of the reactivated patients. Correlation between PAP and PA levels was high, but that between gamma-Sm and PA levels was low. There was no correlation between PAP and gamma-Sm levels. In conclusion, PAP is the most valuable marker for prostatic cancer, and gamma-Sm is of value for use in combination with PAP. However, an additional PA assay was not found to be of advantage.     

Multiple marker evaluation in prostatic cancer using prostatic specific antigen, gamma-seminoprotein and prostatic acid phosphatase

Serum prostatic specific antigen (PA), gamma-seminoprotein (gamma-Sm) and prostatic acid phosphatase (PAP) were evaluated in 141 patients with prostatic cancer, 121 of whom were newly diagnosed. Of the 121 untreated patients, 77, 71 and 67% were detectable by the PA, gamma-Sm and PAP markers, respectively. PA was equally or more sensitive in all stages than the other two markers. Using the benign prostatic hypertrophy group (131 patients) as a negative control, the specificities of PA, gamma-Sm and PAP were 89, 76 and 83%, respectively. Combination of PA, gamma-Sm and PAP increased sensitivity to 86%, especially in localized disease (stages A, B and C) to 74%, but did not improve specificity (67%) or efficiency (76%). During the follow-up period of 1-53 months, 24 of 141 patients with prostatic cancer had disease progression. All serial levels of gamma-Sm, PA, and PAP were positive in 17, 12 and 10 of the 24 patients within 6 months prior to detectable disease progression. gamma-Sm appeared to be more sensitive than the other two markers for early detection of disease progression. These results suggest that PA and gamma-Sm are reliable markers for detection and monitoring of prostatic cancer.     

Clinical studies of gamma-seminoprotein in prostatic disease. I. Clinical evaluation of serum gamma-seminoprotein

Serum gamma-seminoprotein (gamma-Sm) in patients with prostatic disease was determined by enzyme immunoassay. A total of 136 patients including 13 untreated and 40 treated patients with prostatic cancer, 45 patients with benign prostatic hyperplasia (BPH) and 38 patients with other urological diseases were analyzed. The mean +/- SD of serum gamma-Sm in the 13 patients with untreated prostatic cancer and the 45 patients with BPH was 31.7 +/- 46.1 and 3.7 +/- 6.6 ng/ml, respectively, there being a statistically significant difference between the two groups. All patients with untreated stage A or B prostatic cancer had a serum gamma-Sm of less than 4 ng/ml (cut off value). The mean level of serum gamma-Sm was 5.1 +/- 1.9 ng/ml for all patients with untreated stage C prostatic cancer; 66% of them had a value above the cut off value. However, it was 55.9 +/- 52.6 ng/ml in all patients with untreated stage D prostatic cancer; 87.5% of them had a value above the cut-off value. These results suggest that gamma-Sm may be a useful tumor marker in the management of patients with prostatic cancer.     

Clinical evaluation of gamma-seminoprotein in prostate cancer

Gamma-seminoprotein (gamma-Sm), a potential new marker for prostate cancer, has been evaluated with a sandwich-type enzyme immunoassay (EIA). This assay system has been confirmed to have a sensitivity and detectable range of 3.0 and 3.0-100 ng/ml, respectively, with a high reproducibility (approximately equal to 6% coefficient of variation between assays). A total of 256 serum samples were drawn from normal Japanese subjects for detection of gamma-Sm. Serum gamma-Sm was undetectable (less than 3.0 ng/ml) in 26 samples from 26 females. In 230 male cases, serum gamma-Sm levels ranged from less than 3.0 to 4.0 ng/ml. These values were not related to age. An upper normal limit of 3.6 ng/ml was calculated for 99 percentile Japanese males (n = 103) over 50 years of age. Serum gamma-Sm was detected in 192 untreated male patients with urological diseases. Gamma Sm levels (mean +/- SD) in each disease were as follows: prostate cancer (n = 64) 11.0 +/- 17.9 ng/ml; benign prostatic hypertrophy (n = 50), 3.02 +/- 0.113; bladder cancer (n = 58), 3.13 +/- 0.514; and renal adenocarcinoma (n = 30), 3.26 +/- 1.01. Serum gamma-Sm levels were statistically higher (p less than 0.05) in the prostate cancer group, however, there was no statistical difference in gamma-Sm levels among clinical stages or histopathologic grades. Furthermore, serum gamma-Sm values showed no correlation (r = 0.3870) with prostatic acid phosphatase (PAP), but were slightly correlated to prostate antigen (PA) levels (r = 0.6980) in patients with prostate cancer. These results suggest that gamma-Sm is a potential tumor marker of prostate cancer and that serially detected serum gamma-Sm levels could be used to monitor the disease.     

Clinical study of tumor markers in prostatic carcinoma--an investigation on the simultaneous measurement of prostatic acid phosphatase (PAP), prostatic antigen (PA) and gamma-seminoprotein (gamma-Sm)

Measurements of prostatic acid phosphatase (PAP), prostatic antigen (PA) and gamma-seminoprotein (gamma-Sm) have been found to be clinically useful in the diagnosis of prostatic carcinoma, but, the usefulness of simultaneous measurement has not yet been elucidated. We determined the clinical significance of simultaneous measurement of these markers, especially, the additional measurement of PA or gamma-Sm to PAP in prostatic carcinoma. Each measurement of PAP, PA and gamma-Sm yielded a very low "false" positive rate (0-6.5%) in patients with non-prostatic urogenital disease or benign prostatic hypertrophy (BPH), which was consistent with the results reported so far by other researchers. Eighteen patients with newly diagnosed prostatic carcinoma of a low stage showed a positive rate of PAP in 16.7%, PA in 33.3% and gamma-Sm in 38.9%. Forty patients having a high stage had a positive rate of 67.5% for each of the markers. In patients with BPH, the positive rate was elevated in only 2.6, 5.2 or 3.9% by the additional measurement of PA or gamma-Sm to PAP, or that of gamma-Sm to PA, respectively. This implied that the additional measurement of other markers to PAP or PA produced only a low elevation of the "false" positive rate. The positive rate in patients with prostatic carcinoma of low stage was increased by the additional measurement of PA or gamma-Sm to PAP or that of gamma-Sm to PA. This suggests that in patients with low stage carcinoma, assay with these combinations would be clinically useful to monitor the patient's clinical course.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum gamma-seminoprotein determination in prostatic cancer.

Serum gamma-seminoprotein (gamma-Sm) was evaluated as a new marker for prostatic cancer in comparison with prostatic acid phosphatase (PAP). The sensitivity of gamma-Sm and PAP for untreated prostatic cancer was 81% and 67%, respectively. gamma-Sm showed a higher positive rate over all stages than in benign prostatic hypertrophy (BPH). There was no correlation between gamma-Sm and PAP in prostatic cancer. Improved sensitivity was obtained by simultaneous measurement of gamma-Sm and PAP. Specificity of gamma-Sm and PAP for BPH was 87% and 90%, respectively. gamma-Sm normalized after endocrine therapy for stage D2 more often than did PAP. These results indicate that gamma-Sm is another useful marker to evaluate prostatic cancer.     

Clinical evaluation of serum prostatic specific antigen in prostatic cancer: simultaneous assays of prostatic specific antigen, gamma-seminoprotein and prostatic acid phosphatase in 113 newly diagnosed patients with prostatic cancer

Serum prostatic specific antigen (PA), gamma-seminoprotein (gamma-Sm) and prostatic acid phosphatase (PAP) levels were measured in 113 untreated patients with prostatic cancer and in 137 patients with benign prostatic hypertrophy (BPH). We used a PA-TESTWAKO enzyme immunoassay kit, gamma-Sm enzyme immunoassay kit and PAP radioimmunoassay kit. Of the 113 patients, 81.4%, 73.5% and 69%, respectively, were detectable using a single assay. PA was more sensitive than the other two markers in all stages, especially in localized disease (stages A, B and C). Using the BPH group as a negative control, specificities of PA, gamma-Sm and PAP were 85.4%, 81.0% and 94.2%, respectively. Efficiency was, respectively, 81.2%, 79.6% and 82.8%. In the follow up period, 15 patients presented disease progression. At the time of clinical detectable progression, the sensitivities of PA and gamma-Sm were both 100% (15/15), while 67% (10/15) for PAP. Concerning the sensitivity within 6 months prior to progression, gamma-Sm and PA tended to be more sensitive than PAP in early detection of disease progression. This study shows that PA is more reliable than gamma-Sm and PAP in detecting and staging of prostatic cancer. gamma-Sm and PA appear to be more reliable in earlier prediction of disease progression.     

Significance of prostatic acid phosphatase, gamma-seminoprotein and prostatic specific antigen in the urine. First report: the measurement of PAP, gamma-Sm and PA in the urine of patients with prostatic diseases]

To study the significance of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostatic specific antigen (PA) in urine, we have determined the urinary levels of these proteins in women and infants, in patients without prostatic disease, in patients with benign prostatic hypertrophy, and in patients with prostatic adenocarcinoma. Women and infants were found to excrete little PAP (27.9 +/- 4.8 ng/mg) and undetectable levels of gamma-Sm except one case, and undetectable levels of PA in the urine. The excretion of PAP in patients with prostatic carcinoma who were either castrated, or treated with endocrine therapy was lower than the levels in women and infants, or the levels in patients without prostatic diseases, or the levels in patients with BPH. Urinary excretion levels of gamma-Sm and PA were undetectable in the patients with well-controlled prostatic carcinoma. The present study suggests that the determination of PAP, gamma-Sm and PA in the urine of patients with prostatic carcinoma may become a useful tool for monitoring of the primary locus of the carcinoma, but additional assays of urinary PAP, gamma-Sm and PA should be measured at regular intervals to be concluded.     

Clinical evaluation of serum basic fetoprotein for prostatic cancer--comparative study with PAP, gamma-Sm and PSA]

The clinical significance of serum basic fetoprotein (BFP) in prostatic cancer was investigated together with serum prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PA). Investigated in this study were 40 patients with prostatic cancer, ranging in age from 50 to 85 years (mean age: 69.5 years). According to clinical staging, 3 cases (7.5%) had a stage A disease, 10 cases (25.0%) a stage B disease, 7 cases (17.5%) a stage C disease, and 20 cases (50.0%) a stage D disease. The positive rates for serum BFP, PAP, gamma-Sm, and PSA were 60.0, 45.0, 63.6, and 68.4%, respectively, and these rates increased as the stage advanced. The above results suggest that BFP is the most useful marker of the four for monitoring prostatic cancer. In a combination assay of these four markers, 29 (87.9%) of 33 patients with prostatic cancer could be diagnosed by observing an elevated serum level in one of the markers. This suggests that a combination assay of BFP, PAP, gamma-Sm and PSA in patients with prostatic cancer is useful for diagnosis and monitoring of the disease.     

The significance of serum prostate-specific antigen, gamma-seminoprotein and prostatic acid phosphatase as prostate cancer markers

Prostate-specific antigen (PA), gamma-seminoprotein (gamma-Sm) and prostatic acid phosphatase (PAP) have been evaluated in patients with prostate cancer, benign prostatic hyperplasia (BPH), chronic prostatitis and acute prostatitis. PA has proved to be diagnostically more sensitive than PAP and gamma-Sm for the detection of prostatic cancer. Although PA may be elevated more frequently than PAP and gamma-Sm in patients with BPH, there are possibilities that these patients with elevated PA and normal PAP and gamma-Sm may have prostatic cancer or precancerous conditions not detectable in our routine diagnostic procedures. We report two cases of prostatic cancer with persistently elevated PA and diagnosed after repeated biopsies. Our data suggest that PA is a sensitive and useful tumor marker for the diagnosis of prostatic cancer. PAP and gamma-Sm in combination with PA may serve as more useful for differential diagnosis and confirmation of prostatic cancer.     

Comparison of 3 assay kits of prostate specific antigen in serum of prostatic cancer

The serum prostate specific antigen (PA) of the patients with prostatic cancer were determined with 3 assay kits, the Diagnostic Products Cooperation (DPC) kit, the Eiken kit and the Dainippon Pharmaceutical Co. (MARKIT F) kit. The first 2 assay kits involve radioimmunoassay and the latter EIA. For comparison, prostatic acid phosphatase (PAP) and gamma-seminoprotein (gamma-Sm) were determined using an Eiken kit and Chugai kit. Efficiency of the DPC kit, Eiken kit and the MARKIT F kit for untreated prostatic cancer was 26, 25 and 36%, respectively. The PA level measured using the Eiken kit and the MARKIT F kit both well correlated to the PAP level, but with the DPC kit correlation was slightly low. The PA level measured using the 3 different kits correlated poorly with the gamma-Sm level. The PA values obtained with 3 different assays from patients with prostatic cancer were highly correlated, but showed great differences in the values measured. When the standards used in the DPC kit were analyzed by the Eiken kit, the DPC standards as measured by the Eiken kit had only about half of their assigned values. The same standards were analyzed by the MARKIT F kit, the standards yielded measured values about one third of their assigned values. When the standards used in the MARKIT F kit were analyzed by the Eiken kit, the MARKIT F standards yielded measured values about 2.5 fold of their assigned values. The differences between the values obtained with the 3 assay kits presented a serious problem in clinical use of PA. Standardization of these assay kits will be awaited.     

The significance of prostatic serum acid phosphatase as a tumor marker in prostatic cancer

The levels of prostatic serum acid phosphatase (PSAP) were determined by radioimmunoassay using RIA-Quant PAP test kit on 14 normal females, 56 normal males, 25 patients with prostatitis, 74 patients with benign prostate hypertrophy, 129 patients with prostatic cancer, 50 patients with nonprostatic malignancies, and 16 post radical cystectomized males, making 364 cases in all. To diagnose prostatic cancer, a PSAP level of over 3.0 ng/ml was determined positive for differential diagnosis of prostatitis, benign prostate hypertrophy, and prostatic cancer. According to this criterium, the positive rate for each type of disease was: 0% for prostatitis, 5.4% for benign prostate hypertrophy, 80.6% for untreated prostatic cancer, and 2% for nonprostatic malignancies. In benign prostate hypertrophy, the cases with urethral catheters showed a tendency of high PSAP level, but no significant difference was observed. PSAP positive rates of untreated prostatic cancer by stage are 0% for Stage A, 57.1% for Stage B, 85.7% for Stage C, 100% for Stage D1, and 94.1% for Stage D2 cases at a high stage showing high positive rates. However, there seems to be a limit for the diagnosis of early prostatic cancer. As for the relationship between the grade of untreated prostatic cancer and PSAP, well differentiated tumors showed higher levels of PSAP in the study with cases of the same stage. However, with all the cases, less well differentiated tumors showed higher levels of PSAP. As a tumor marker for prostatic cancer in the observation of treatment response, the PSAP level of over 2.0 ng/ml was determined positive. The relationship between the judgement of treatment response and PSAP was: Objective stable for its increase or decrease within the normal range; progressive disease for its elevation from normal to positive level, or increase or decrease of PSAP level within the positive range; Objective partial regression or objective stable for normalization from positive level. The PSAP level in the internal iliac vein of the patients with prostatic cancer tended to be higher than that in the femoral vein or antecubital vein.     

Serum prostatic acid phosphatase, gamma-seminoprotein and prostatic specific antigen in hemodialysis patients.

Serum concentrations of prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostatic specific antigen (PSA) were measured in 31 hemodialysis patients without clinical signs of malignant disease. PAP, gamma-Sm and PSA levels in serum were not significantly different between control and hemodialysis groups. A significant reduction in these tumor markers was not found after dialysis treatment. This indicates that the measurement of PAP, gamma-Sm and PSA in serum is useful for the detection of prostatic cancer in patients undergoing hemodialysis.     

An evaluation of the immunochemical measurement of prostatic acid phosphatase and prostatic specific antigen in carcinoma of the prostate

Serum prostatic specific antigen (PSA) and prostatic acid phosphatase (PAP) were evaluated with double monoclonal radioimmunoassays. In 250 patients with prostatic cancer the normal limits were as follows: PSA 0.1-2.7 ng/ml, and PAP 1.09 +/- 0.45 ng/ml (mean +/- SD). In 91 untreated patients with non-metastatic tumours, 42.8% had PSA greater than 10 ng/ml and 18.6% had PAP greater than 2 ng/ml. In 60 untreated patients with metastatic disease PSA was greater than 10 ng/ml in 91.7%; PAP was greater than 2 ng/ml in 65%. In prolonged remission PSA was generally less than 5 ng/ml and PAP less than 2 ng/ml. Longitudinal studies of 2-4 years showed the independence of these markers and a higher correlation of changes in the PSA level and clinical status than given by parallel PAP measurements. In non-metastatic disease, PSA greater than 10 ng/ml at presentation, with or without a coincidentally raised PAP, carried an increased risk of progression within 2 years.