Leukocyte Alkaline Phosphatase and Carcinoembryonic Antigen in Lung Cancer Patients

Abstract

Leukocyte alkaline phosphatase (LAP) scores in peripheral blood and plasma carcinoembryonic antigen (CEA) levels were determined in 58 lung cancer patients and compared with those of 22 healthy persons, who served as controls. In the control group we found LAP scores of 54 + 28 and CEA levels of 4 + 3 ng/ml. The 97.7% confidence intervals are: LAP score < 110 and CEA level 10. In the patients with limted lung cancer we found LAP scores of 152.4 + 36.7 and CEA levels of 22.7 + 48 ng/ml. The 97.7% confidence intervals are: LAP score > 78.6 and CEA level > 0. In the patients with extensive lung cancer we found LAP scores of 272 ± 49 and CEA levels of 47.5 + 80.4 ng/ml. The 97.7% confidence intervals are: LAP score > 174 and CEA level > 0. The sensitivity of each marker is discussed, here as percent of false-negative results, denoted PFN, and meaning that with a chosen threshold for the marker level, only PFN% of the patients with a given condition (e.g. extensive lung cancer) might have a marker level less than the chosen threshold and could therefore be assumed healthy. The sensitivity of the LAP score is 0.05% PFN for the group of patients with extensive lung cancer, and we conclude that indeed LAP score 110 indicates a very low probability of having extensive malignancy. The sensitivity of the CEA level is 32% PFN. The sensitivity of the LAP score to limited lung cancer is 12% PFN for the group of patients with that condition compared with 40% of CEA. The specificities of both LAP score and CEA levels, expressed as percent of false-positive results in the control group, are fair (2.3%), provided that the common conditions, other than cancer, that elevate LAP score and/or CEA levels are well known and can be eliminated by the physician. It is concluded that the LAP score is considerably more useful than the CEA level as a marker for extensive lung cancer.

Leukocyte Alkaline Phosphatase as a Probable Predictor of the Metastatic State in Breast and Colon Cancer Patients

“…In all cases that have been studied in Assaf Harofeh [1][2][3][4][5] as well as in the present work it was found out that whenever métastasés were diagnosed in a patient, the LAP score was much higher than its regular value for that patient. Thus the present study shows that the LAP test yields an earlier detection of métastasés in many cases.…”

“…In a previous paper we showed that the average LAP score in metastatic patients is significantly higher than in nonmetastatic patients, but the overlap between 95% confidence level ranges of the scores of metastatic patients and nonmetastatic patients is such that there is no reliable threshold value that could distinguish between the stages [5], In this study we consider the LAP scores of nonmetastatic patients that were tested for LAP score as a part of their periodical checkups and who later became metastat ic. The purpose of this study is to observe, in the same patient, the time behavior of his LAP scores, and to find out if there was a rise in the LAP score that started before métastasés have been diagnosed by the usual methods, and thus could have served as a predictor and warning signal to the physician.…”

“…Elevated LAP scores have been found in different clinical and hematological disorders and solid tumors and could be used as a biologic nonspecific marker in cancer [1]. This enzyme is useful in detecting metastatic malignan cies in different tumors like breast cancer [2], colorectal cancer [3,4], lung cancer [5], and other malignant diseases [ …”

Effects of retinoic acid on N‐glycosylation and mRNA stability of the liver/bone/kidney alkaline phosphatase in neuronal cells

“…Determination of ALP activity is frequently used in clinical medicine. The cancer-related research of the enzyme is focused on the eutopic or ectopic expression of ALP in several malignancies including brain tumors (Takahara et al, 1982;Curatolo et al, 1992;Bacci et al, 1993;Hoshino et al, 1993;Moro et al, 1993;Stieber et al, 1993;Walach and Gur, 1993). An understanding of the reasons underlying increased expression of ALPs may provide insights into the process of carcinogenesis and normal functions of the enzyme.…”

Chemiluminescent determination of leukocyte alkaline phosphatase: an advantageous alternative to the cytochemical assay

“…The determination of LAP may also be used for other purposes, such as to evaluate neutrophilic function (5), discriminate chronic neutrophilic leukemia (6), and as complementary laboratory criteria to discriminate between polycythemia vera and secondary polycythemia (7). In addition, the LAP assay has been proposed as a means of distinguishing between malignant and benign paraproteinemias (8), as a predictor of the metastatic state of breast and colorectal cancer (9), and as a prognostic test for lung cancer (10). It is possible that further applications for LAP determination will be discovered in the future.…”