Abstract
The Regan isoenzyme (RI) of alkaline phosphatase is interesting because it is indistinguishable from the placental isoenzyme with regard to stability to heat, inhibition by L-phenylalanine, optimum pH. and specific reaction with rabbit antisera to placental alkaline phosphatase. The current study of 323 cancer patients was conducted at a general hospital where cancer is more frequently seen at an earlier stage of natural history and therapy than in a chronic disease hospital. A positive identification of RI was made in 39 patients (12%) by biochemical and immunologic techniques, including antibody neutralization and starch gel electrophoresis. A high incidence of carcinoma of the ovary (5 of 23) and seminoma (one of one) patients contrasted to a somewhat lower incidence in bronchogenic carcinoma (7 of 51) and breast cancer (6 of 49). Most interesting was the discovery of high RI levels in familial polyposis of the colon, and ulcerative colitis, diseases with a known cancer diathesis. In general, RI dropped sharply following treatment with effective antimetabolic chemotherapeutic agents. The ectopic production of this protein enzyme, interpreted as a consequence of derepression of the tumor cell genome, is comparable with other polypeptide hormone syndromes, or carcinoembryonic antigens, but evidences a wider variety of sites of tumor origin. Its identification in gonadal tumors and in precancerous states may represent a predeliction of such derepression for tissues concerned with germinal activity or with genetically determined cancer diathesis, respectively.
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