Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.1.3.1 (alkaline phosphatase)
47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between May 1980 and July 1983, the RTOG conducted a randomized prospective study comparing external radiation therapy and misonidazole to radiation therapy alone for patients with hepatic metastases. Two hundred fourteen patients were accessioned to this study of whom 187 were evaluable. Radiation therapy was delivered to the whole liver to a dose of 21.0 Gy in 7 fractions. Misonidazole was administered orally, 1.5 gm/m2 daily 4-6 hr before each treatment. Patients in the two treatment groups were evenly distributed with respect to stratification variables including primary site, extent of metastatic disease, and Karnofsky Performance Score (KPS). End points examined included amelioration of hepatic pain, improvement of KPS and alkaline phosphatase, decrease in liver and tumor size, and survival. The addition of misonidazole did not significantly improve the therapeutic response to radiation therapy in any of the parameters studied. Hepatic irradiation was effective in relieving abdominal pain with 80% of the symptomatic patients achieving improvement following therapy. Pain was completely relieved in 54% of these patients. Patients with liver metastases from colon carcinoma improved more frequently than those with metastases from other primary tumor sites (p = 0.02). Relief of pain occurred more frequently in patients treated with radiation therapy and misonidazole (87%) compared with radiation therapy alone (74%) (p = 0.08). Palliation of pain was prompt, occurring within a median of 1.7 weeks from the initiation of treatment, and 94% of patients who improved did so within 6 weeks of treatment. The median duration of response was 13.0 weeks in the symptomatic patients; 52% of those surviving 3 months remained improved. KPS improved in 28% of patients. Serial CT scans revealed a partial response in 7% and a marginal response in 13% of patients. One patient had a complete response to treatment. The median survival of patients treated in this series was 4.2 months with no difference between the two treatment groups. Patients with metastases from colon carcinoma and an initial KPS of 80 or more (48% of the patient population) had a median survival of 5.8 months with radiation therapy alone compared with 6.6 months with radiation therapy and misonidazole (p = 0.36). There was no significant treatment related morbidity. Radiation therapy remains an excellent palliative tool for the management of patients with symptomatic hepatic metastases. Further research must continue to identify new methods of selectivity enhancing the tumor response to radiation therapy.
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PMID:A comparison of misonidazole sensitized radiation therapy to radiation therapy alone for the palliation of hepatic metastases: results of a Radiation Therapy Oncology Group randomized prospective trial. 359 49

Potential pretreatment prognostic variables for patients presenting with liver metastases at the time of resection of primary colorectal cancers were evaluated in 42 consecutive patients resected over two years. Survival was bimodal with 12 patients dead within 6 months of surgery and the remaining patients dead or alive at follow-up at 6 to 27 months (median 9 months). Preoperative peripheral lymphocytes (P = 0.0008), alkaline phosphatase (P = 0.0056), and serum glutamic oxaloacetic and pyruvic transaminases (SGOT, P = 0.0048, and SGPT, P = 0.0031) were significant prognostic factors. The transaminases were prognostic within the normal ranges for the hospital laboratory. Age, sex, hematocrit, platelet count, bilirubin, cholesterol, albumin, protein, creatinine, tumor differentiation, bowel penetration, nodal involvement, operative blood loss, transfusions and chemotherapy were not related to survival. These results indicate that normal liver function tests in patients with colorectal liver metastases have significant prognostic value. Immune function as reflected by lymphocyte count may also play a role in these patients' survivals.
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PMID:Pretreatment prognostic factors in colorectal cancer patients with synchronous liver metastases. 369 21

Thirty-eight consecutive patients with liver scan evidence of hepatic metastases (and confirmation by other modalities) had blood levels of lactate dehydrogenase and alkaline phosphatase performed within two weeks. In 38% of the patients with small liver metastases, both alkaline phosphatase and lactate dehydrogenase were in the normal range. Even with large metastases present (one or more lesions over 2.5 cm in diameter), 19% of the patients had both enzyme tests within the normal range. Despite the lower cost of these enzyme assays, they failed to detect hepatic metastases in an appreciable portion of our patients.
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PMID:Liver function tests. A study in patients with imaging-demonstrated metastases. 369 34

The prognostic value of serial CEA tests was evaluated in 175 consecutive patients with progressive colorectal cancer who subsequently died of their disease. The upper normal plasma CEA limit was determined to be 8 ng/ml from serial CEA determinations in 31 patients radically operated on for colorectal cancer and observed in median 40 months without evidence of recurrence. A CEA value of greater than 8 ng/ml was highly suggestive of residual disease or recurrence, even when no clinical evidence was present. Approximately 90% of the patients dying from colorectal cancer showed an increase in CEA to greater than 8 ng/ml during the course of the disease. In 63% of the patients CEA increase preceded clinical progression or relapse, with a median time period of 4 months. Sixty-eight per cent of the patients had rising CEA values over an extended time period of many months, 14% had a preterminal increase, 13% had constantly normal and 5% constantly elevated CEA. As 6/9 patients developed a drop in CEA in relation to initiation of chemotherapy without clinical response, it is concluded that CEA is not a reliable indicator of clinical response to chemotherapy. Patients with liver metastases had higher CEA and alkaline phosphatase levels than patients with only localized disease. However, no good statistical correlation between CEA and serum alkaline phosphatase was found in patients with liver metastases (coefficient of correlation r = 0.35). An increase in CEA from normal to above 8 ng/ml predicted a decrease in survival time of median 60% counted from the time of diagnosis. The numerical CEA value was predictive of shortening of survival only when greater than 3000 ng/ml. Such high values were observed only in a minority of the patients (12%). Greater than 1000 U/l (27% of the patients) alkaline phosphatase predicted an extremely poor prognosis, with a median survival of 1 month (range 0.5-4 months). It is concluded that a rise in CEA to greater than 8 ng/ml indicates with high degree of certainty relapse or disease progression in colorectal cancer patients. CEA is not a reliable indicator of clinical response to chemotherapy, and an increase in the CEA level is of little prognostic value concerning survival. Alkaline phosphatase seems to be a more valuable predictor of a worsening of prognosis.
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PMID:Carcinoembryonic antigen (CEA) and alkaline phosphatase in progressive colorectal cancer with special reference to patient survival. 369 82

In a population-based study of 402 cases of colorectal cancer in Auckland, 72 patients (18%) demonstrated liver metastases either at presentation or at initial surgery. The findings of pre-operative weight loss, hepatomegaly and elevated alkaline phosphatase were significantly associated with heptic metastases. Individually these factors were insensitive indicators of the presence of liver metastases. Two or more of these risk factors were demonstrated by 54% of the patients with liver secondaries compared to 19% in the series without liver metastases. Continuing surveillance of the latter group of patients will show whether they are also at risk of developing liver secondaries. The median survival for the 69 patients who were diagnosed before death was 6.0 months. When the primary lesion was resected and the patient survived the post-operative period the median survival was 11.0 months.
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PMID:Colorectal cancer in Auckland 1981-1982: patients with liver metastases. 386 34

A consecutive series of 100 patients affected by gastrointestinal malignancies entered a prospective controlled study of liver metastases performed by ultrasound echography, CEA, hepatic enzymes (only alkaline phosphatase (AP) was found to be somehow significant). Laparotomic inspection and palpation were taken as objective control of ultrasound scan. Eighteen out of the 100 patients showed diffuse hepatic metastases at surgery (all controlled histologically). Hepatic echography correctly diagnosed liver metastases in 15 out of these 18 patients (= 83.8% sensitivity); two more cases (hepatic fibroangiomas) were interpreted as metastases (= 89.9% specificity). CEA-RIA assay was pathologic (greater than 10 ng/ml) in all of the 18 patients with liver metastases; 21 out of the 82 without liver metastases were CEA positive (difference of mean values statistically significant at P less than 0.01). The only significant hepatic enzyme was AP, which was pathologic in 12 out of 18 patients with liver metastases. The comparative evaluation of the three tests showed that ultrasound scanning missed three cases of diffuse hepatic metastases, which, however, were CEA positive, while AP could not help to correct such misdiagnosis.
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PMID:Combined ultrasounds and CEA in preoperative assessment of hepatic metastases from gastrointestinal malignancies. 388 60

Surgeons' ability to predict liver metastases preoperatively was studied in 185 operable, nonicteric patients strongly suspected to have gastrointestinal cancer. The prediction was based on a clinical assessment comprising medical history, physical examination and low-cost laboratory tests. A pathoanatomic verification procedure was used. The observed predictive value of a positive test was 0.67 and there was a false-negative ratio of 0.79. At the clinical assessment, presence of metastases was believed to be more common in gastric than in colorectal disease (6/43 vs. 3/142), but the actual incidence of metastases was similar in the two groups. Serum alkaline phosphatase (AP) was a priori believed to be of value in the clinical assessment. But the clinical assessment with inclusion of AP was inferior to AP alone as a predictor of metastases, due to undervaluation of the importance of elevated AP in cases of colorectal disease. The difficulties in standardization of the clinical assessment are underlined.
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PMID:The value of clinical assessment for preoperative prediction of liver metastases in suspected gastrointestinal cancer. A prospective, consecutive study. 395 16

Liver scintigraphy (99Tcm sulphur colloid) was performed in 118 patients with malignant melanoma. In 73 patients diagnosed as stage I, the pretreatment evaluation showed one false-negative and one false-positive examination. During follow-up there were ten abnormal liver scintigraphies; one was later correlated to liver metastases. In 46 patients diagnosed as stage II-IV, the pretreatment liver scintigraphy yielded false-negative results in 36% and false-positive results in 15%. The predictive values of positive and negative tests were 44% and 81%, respectively. The yields of liver tests (S-alkaline phosphatase, S-gamma-glutamyl-transferase) in patients with liver metastases were low. This study demonstrated the limitations of liver scintigraphy for diagnosis of liver metastases in patients with malignant melanoma.
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PMID:Value of liver scintigraphy in pretreatment staging and in follow-up of patients with malignant melanoma. 399 Mar 6

An alkaline phosphatase immunochemically similar to placental alkaline phosphatase (EC 3.1.3.1) was purified from liver metastases of a giant-cell carcinoma of the lung. Some properties of its physical and chemical structure were determined and compared to those of purified placental alkaline phosphatase. The purified tumor phosphatase and the placental phosphatase were similar with regard to the following properties: (1) NH(2)-terminal sequence, (2) peptide map, (3) subunit molecular weight, and (4) isoelectric point. The physical properties and NH(2)-terminal sequence of alkaline phosphatase isoenzyme of liver differed from the placental and the tumor enzyme. The data from the present study strongly support the hypothesis that the tumor and the placental alkaline phosphatases are products of the same gene.
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PMID:Structual comparison of ectopic and normal placental alkaline phosphatase. 451 47

Clinical, serological and lymphocyte studies were done on 435 patients with biopsy proved anaplastic nasopharyngeal carcinoma (NPC) in various clinical status, at the National Taiwan University Hospital, from January 1980 through June 1983. Studies on 134 normal control were also done. Using immunofluorescent antibody method, seropsitive rates of the antibody titers against viral capsid antigens (VCA) and early antigens (EA) of Epstein-Barr (EB) virus were 70.8%-100% for anti-VCA/IgG titers (greater than or equal to 1:640), 81.0%-100% for anti-VCA/IgA titers (greater than or equal to 1:40), 66.7%-93.8% for anti-EA/IgG titers (greater than or equal to 1:160), and 40.0%-87.5% for anti-EA/IgA titers (greater than or equal to 1:40) in NPC patients with disease. They decreased to 10.5%-21.7% in remission patients. In contrast, they were less than 5% in the control. Mean total serum IgG and IgA levels were moderately increased to around 1,500 mg/dl and 300 mg/dl respectively, in all patients. The increase was most remarkable in patients with liver metastases. In control the values were 1,211 mg/dl and 223 mg/dl, respectively. Mean serum IgM, C3 and C4 amounts of NPC patients were not significantly different from those of the normal control, the latter were 129, 80.3 and 43.2 mg/dl, respectively. Serum acid phosphatase and calcium levels of NPC patients were all in the normal range of 0.1-2.0 BU/ml and 2.0-3.0 mmol/dl, respectively. Serum GOT, GPT, alkaline phosphatase, lactate dehydrogenase and mucoprotein were elevated either alone or in combination in some patients before treatment, in many patients with neck recurrence or distant metastases, but in all patients with liver metastases. Using monoclonal antibodies (Ortho Inc., U.S.A.) to define lymphocyte subsets, B lymphocytes comprised about 12% and T lymphocytes about 60% in the patients, whereas they were 11.9% and 73.1% in the control. The helper/suppressor ratio was 1.7 in the control and about 1.0 in NPC patients, and was only 0.8 in remission patients. The lack of correlation between the seropositive rates of anti-VCA antibodies and the helper/suppressor ratio might indicate different manifestations of humoral and cellular immunity in patients with NPC.
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PMID:Humoral and cellular immunity in patients with nasopharyngeal carcinoma. 608 49


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