Rise of Serum-Acid-Phosphatase Level Following Palpation of the Prostate

Daniel, Owen; Zyl, J.J. Van

doi:10.1016/s0140-6736(52)90643-0

Cited by 49 publications

(11 citation statements)

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“…This amount is believed to represent non-prostatic sources of acid phosphatase which are inhibited by L-tartrate (11). In our experience so far, this non-prostatic source does not interfere in the interpretation of the values for "prostatic" acid phosphatase.…”

Section: Fig 5 a Study Of A Patient With Cancer Of The Prostate Shomentioning

confidence: 64%

“…Thus, prostatic massage results in a significant increase of the fraction of serum acid phosphatase inhibited by L-tartrate more often than of the total acid phosphatase. The fact that palpation of the prostate in 10 per cent of patients without cancer of the prostate does give rise to a subsequent increase in 10)42 serum acid phosphatase is known (10,11). In cancer of the prostate the "prostatic" acid phosphatase in the serum is elevated on every occasion when one encounters a high serum acid phosphatase.…”

Section: Discussionmentioning

confidence: 99%

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A New Method for Estimating Serum Acid Phosphatase of Prostatic Origin Applied to the Clinical Investigation of Cancer of the Prostate 12

Fishman¹,

Dart²,

Bonner³

et al. 1953

J. Clin. Invest.

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Since the studies of Gutman and Gutman (2, 3), measurements of the serum acid phosphatase have become a recognized and widely used ancillary procedure for the diagnosis of cancer of the prostate and a practical means for the evaluation of the functional status of the tumor in many patients with metastasizing cancer of the prostate. While an abnormally increased value of serum acid phosphatase is considered to be a specific index for the presence of carcinoma of the prostate, a normal serum acid phosphatase value in itself cannot be interpreted as signifying absence of this disease. According to Bodansky and Bodansky (4) Attempts have been made to render the determination of serum acid phosphatase more specific for cancer of the prostate. Thus, a search has been made for substrates which would be split prefer-

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Section: Fig 5 a Study Of A Patient With Cancer Of The Prostate Shomentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

A New Method for Estimating Serum Acid Phosphatase of Prostatic Origin Applied to the Clinical Investigation of Cancer of the Prostate 12

Fishman¹,

Dart²,

Bonner³

et al. 1953

J. Clin. Invest.

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“…Hock and Tessier (1949) reported elevation of the serum AcPase above the initial value in 17 of 20 patients undergoing rectal examination. In three out of 24 patients with benign cystic hypertrophy, significant elevation of serum AcPase activity occurred after rectal examination, probably as a consequence of rupture of cysts releasing enzyme-rich secretion into the blood (Daniel and Van Zyl, 1952). Elevations were also reported under similar circumstances in some patients with prostatic cancer (Bonner, Homburger, and Fishman, 1954), and as a common sequel to handling of the prostate during transvesical enucleation of the gland (Romslo, 1971 Christensen and Nielsen, 1972).…”

Section: Subjects With Prostatic Cancermentioning

confidence: 89%

An assessment of serum acid and alkaline phosphatase determinations in prostatic cancer with a clinical validation of an acid phosphatase assay utilizing adenosine 3′ -monophosphate as substrate

Goldberg¹,

Ellis²

1974

J Clin Pathol

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SYNOPSIS Serum acid phosphatase (AcPase) was measured by a colorimetric method utilizing adenosine 3'-monophosphate as substrate in 389 patients. In about half the cases blood was taken shortly after a rectal examination. The upper reference limit (mean + 2SD) for 116 cases with miscellaneous illness after eliminating outliers was 4f1 International Units per litre (U/I) at 37°C, and no correlation existed between AcPase activity and age in these subjects (r = 0 040). Eight of 18 patients with untreated carcinoma confined within the prostate gland had AcPase activities below 4-1 U/1, and all of 27 cases with extension to pelvic soft tissues or to bone exceeded this value. AcPase activities above 4f1 U/l were found in 6% of cases with benign hypertrophy of the prostate, in 5% of cases with non-prostatic cancer, and in none of 22 cases with other urological illness.Raised serum alkaline phosphatase (APase) activity was found in 60% of patients with untreated prostatic cancer and in only 6% of patients free of prostatic cancer, in most of whom there was a clinical explanation for the elevation. The correlation between the two phosphatase activities was not significant (r = 0.294). While APase activity does not reflect the stage of the disease as closely as AcPase activity, and is not so frequently elevated, it provided useful confirmation of the diagnosis in five patients of the present series whose AcPase levels were normal or only minimally elevated.

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“…The evidence for the generally held belief that rectal examination causes misleading elevation of serum acid phosphatase is largely provided by the reports of Hock and Tessier (1949), Daniel and Vanzyl (1952), Bonner et al (1954) and Glenn and Spanel (1959). The study of Daniel and Vanzyl (1952) showed that in only 9-7% of the patients did rectal examination produce elevated acid phosphatase.…”

Section: Discussionmentioning

confidence: 99%

The effect of rectal examination on serum acid phosphatase levels in benign and malignant prostatic disese

Osegbe

Magoha

1982

Postgraduate Medical Journal

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Summary Serum acid phosphatase was measured in patients with enlarged benign and malignant prostate before and after rectal examination. Amongst the patients with benign glands, rectal examination did not produce any significant false elevation of the enzyme. Rectal examination, however, caused a rise in the enzyme level in a few untreated cancer patients and in cancer patients who had become refractory to hormonal therapy. This rise would help rather than mislead in the diagnosis of malignant prostate and also in identifying treated patients who had become refractory to treatment. Thus, when serum acid phosphatase is properly determined, elevated levels should always arouse suspicion of malignant prostate or other lesions associated with high enzyme level even if such determination was preceded by rectal examination. There appears to be no merit in the teaching that the determination of serum acid phosphatase should be delayed after rectal examination.

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Rise of Serum-Acid-Phosphatase Level Following Palpation of the Prostate

Cited by 49 publications

References 1 publication

A New Method for Estimating Serum Acid Phosphatase of Prostatic Origin Applied to the Clinical Investigation of Cancer of the Prostate 12

A New Method for Estimating Serum Acid Phosphatase of Prostatic Origin Applied to the Clinical Investigation of Cancer of the Prostate 12

An assessment of serum acid and alkaline phosphatase determinations in prostatic cancer with a clinical validation of an acid phosphatase assay utilizing adenosine 3′ -monophosphate as substrate

The effect of rectal examination on serum acid phosphatase levels in benign and malignant prostatic disese

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