Summary
Serum acid phosphatase activity is known to be elevated in a number of patients with metastatic prostatic carcinoma. Prostatic acid phosphatase (PAP) can be specifically measured by immunological methods. In this study we evaluated an enzyme-immunoassay of the sandwich type utilizing monoclonal antibodies.
Immunoassayable PAP decreased after storage at room temperature for 72 h and also after repeated freezing and thawing, although not evident in all samples. PAP levels were measured in 88 newly diagnosed prostatic carcinoma patients, in 124 patients with histologically proven benign prostatic hypertrophy (BPH) and in 124 elderly hospitalized male patients without urological complaints. The upper limit of normal, as determined in the control group, was 2.3 μg/l.
Of the BPH patients, 17% had elevated PAP levels (range 2.4–27 μg/l). We found a positive correlation between prostate volume (grams of tissue removed during TUR) and preoperative PAP values (r=0.26, N=121, P<0.01). Elevated PAP levels were found in 3% of BPH patients with a prostate volume of less than 20 g (N=63), in contrast with 55% of patients with a prostate volume above 50 g (N=18).
The sensitivity of this PAP assay for detecting the clinical stages of prostatic carcinoma was 13% for category To (N=15), 30% for category T1–2 (N=20), 71% for category T3–4 (N=24), and 83% for category M1 or N1–4 (N=29).
The upper limit of normal (2.3 μg/l) as calculated from a large group of controls with a mean age of 62 years is rather similar to the value found in younger controls. In BPH patients, however, elevated PAP levels may be found which are seen more frequently in patients with a large prostate. Thus, for the calculation of the normal range, it is not recommended to include the results from BPH patients. The sensitivity of this enzyme-immunoassay with monoclonal antibodies in detecting prostatic cancer, at a specificity of 98%, is comparable to other immunoassays for PAP.
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Oosterom, R., Leijnse, B., Bogdanowicz, J. et al. Evaluation of an enzyme-immunoassay for prostatic acid phosphatase utilizing monoclonal antibodies. World J Urol 4, 153–158 (1986). https://doi.org/10.1007/BF00327012
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DOI: https://doi.org/10.1007/BF00327012