Urinary Cholesterol in Cancer: Urinary Cholesterol Excretion in Cancer Patients and Control Subjects

Abstract

THiE application of the methods of urinary cholesterol estimation given by Burchell and Maclagan (1949) to cancer and control cases will now be described. BMATERIALUrine specimens were obtained from 13 normal subjects and 116 patients admitted to Westminster Hospital or to Westminster Hospital (.All Saints') Urological Centre. Twenty-five of these patients were suffering from diseases thought to be unlikely to affect cholesterol excretion as shown in the tables, and 73 were suffering from various forms of cancer. The remaining 18 were patients suffering from haematuria or pyuri3 of non-malignant origin. The diagnosis in the cancer group was established in most caes by laparotomy (3), biopsy (38) or autopsy (12), but in 20 cases the diagnosis was based on unequivocal X-ray or other clinical data.Collection and treatment of specimens.Preliminary results having shown that a considereble amount of cholesterol might be associated with the urinary sediment in certain cases, a routine procedure was adopted to standardize the treatment of the sediment.Twelve-hour specimens of urine were collected into clean winchesters, the time of the collection being usually between the hours of 6 p.m. and 6 a.m.The volume of specimen was measured, the urine adjusted to pHE 5-0 with acetic acid and, if urates were present, warmed to 37°C. Cell counts on the urinary depo/it (UD) were carried out by the method of Addis (1925) on a 10 ml. portion of the well-mixed specimen. For cholesterol estimation on the deposit a 500 ml. sample of the mixed specimen, or a smaller aliquot in the case of a concentrated urine, was centrifuged, the deposit washed once with normal saline and extracted directly with three portions of boiling acetone. The acetone extract was evaporated to dryness, and the residue extracted with petroleum ether for the determination of cholesterol as above.The cholesterol content of the supernatant urine (SU) was determined on 200 ml. portions by the aluminium tungstate method described by Burchell and Maclagan (1949 Similarly, any patient with haematuria or pyuria may be expected to show an increase in the UD cholesterol as shown in Table I. In this group of cases an attempt was made to correlate the cholesterol content of the UD) with quantitative cell counts, and although no exact correlation could be established, it will be noted that the three highest cholesterol values were associated with the highest cell counts. Pyuria was the commonest accompaniment of raised UD cholesterol in this series, but increase in red cells and epithelial cells appear to be significant in cases No. 137 and 152. It is evident from these results that a careful examination of the urinary deposit must accompany any cholesterol estimation if the result is to be Fig. 4, and full details of these patients are given in Table II The UD cholesterol results in 4 cases of cancer with haematuria or pyuria (leucocyte counts above 100 millions per 12 hours) were shown in Table I, but it will be seen that the high values here were equally distribut...