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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1987 Apr;40(4):398–403. doi: 10.1136/jcp.40.4.398

Identification of bone and liver metastases from breast cancer by measurement of plasma alkaline phosphatase isoenzyme activity.

P D Mayne, S Thakrar, S B Rosalki, A Y Foo, S Parbhoo
PMCID: PMC1140971  PMID: 3584482

Abstract

Plasma alkaline phosphatase isoenzyme activities were determined in patients with breast cancer to diagnose and monitor bone and liver metastases. Bone alkaline phosphatase activity was increased in 21 of 50 patients (42%) with radiologically confirmed bone metastases, while total alkaline phosphatase activity was increased in only 10 of 50 (20%); liver alkaline phosphatase activity was raised in 12 of 25 patients (48%) with liver metastases. All patients with liver metastases had bone metastases. Bone alkaline phosphatase activity was significantly higher in patients with symptomatic bone disease. Isoenzyme determination provided additional information that would have changed patient management in five of 20 patients who were monitored serially. Measurement of alkaline phosphatase isoenzyme activity, though less sensitive than imaging procedures, can assist in screening for, and in early detection of, a high proportion of bone and liver metastases, and can provide useful objective evidence of their response to treatment.

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Selected References

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  1. Coombes R. C., Powles T. J., Gazet J. C., Nash A. G., Ford H. T., McKinna A., Neville A. M. Assessment of biochemical tests to screen for metastases in patients with breast cancer. Lancet. 1980 Feb 9;1(8163):296–297. doi: 10.1016/s0140-6736(80)90790-4. [DOI] [PubMed] [Google Scholar]
  2. Karmen C., Mayne P. D., Foo A. Y., Parbhoo S., Rosalki S. B. Measurement of biliary alkaline phosphatase by mini-column chromatography and by electrophoresis and its application to the detection of liver metastases in patients with breast cancer. J Clin Pathol. 1984 Feb;37(2):212–217. doi: 10.1136/jcp.37.2.212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Moss D. W. Alkaline phosphatase isoenzymes. Clin Chem. 1982 Oct;28(10):2007–2016. [PubMed] [Google Scholar]
  4. Perez D. J., Powles T. J., Milan J., Gazet J. C., Ford H. T., McCready V. R., MacDonald J. S., Coombes R. C. Detection of breast carcinoma metastases in bone: relative merits of X-rays and skeletal scintigraphy. Lancet. 1983 Sep 10;2(8350):613–616. doi: 10.1016/s0140-6736(83)90692-x. [DOI] [PubMed] [Google Scholar]
  5. Posen S., Grunstein H. S. Turnover rate of skeletal alkaline phosphatase in humans. Clin Chem. 1982 Jan;28(1):153–154. [PubMed] [Google Scholar]
  6. Rhone D. P., Berlinger F. G., White F. M. Tissue sources of elevated serum alkaline phosphatase activity in hyperthyroid patients. Am J Clin Pathol. 1980 Oct;74(4):381–386. doi: 10.1093/ajcp/74.4.381. [DOI] [PubMed] [Google Scholar]
  7. Roberts J. G., Gravelle I. H., Baum M., Bligh A. S., Leach K. G., Hughes L. E. Evaluation of radiography and isotopic scintigraphy for detecting skeletal metastases in breast cancer. Lancet. 1976 Jan 31;1(7953):237–239. doi: 10.1016/s0140-6736(76)91351-9. [DOI] [PubMed] [Google Scholar]
  8. Rosalki S. B., Foo A. Y. Two new methods for separating and quantifying bone and liver alkaline phosphatase isoenzymes in plasma. Clin Chem. 1984 Jul;30(7):1182–1186. [PubMed] [Google Scholar]
  9. Sahm D. F., Murray J. L., Munson P. L., Nordquist R. E., Lerner M. P. Gamma-glutamyltranspeptidase levels as an aid in the management of human cancer. Cancer. 1983 Nov 1;52(9):1673–1678. doi: 10.1002/1097-0142(19831101)52:9<1673::aid-cncr2820520921>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  10. Stolbach L. L., Krant M. J., Fishman W. H. Ectopic production of an alkaline phosphatase isoenzyme in patients with cancer. N Engl J Med. 1969 Oct 2;281(14):757–762. doi: 10.1056/NEJM196910022811403. [DOI] [PubMed] [Google Scholar]
  11. Vecchio T. J. Predictive value of a single diagnostic test in unselected populations. N Engl J Med. 1966 May 26;274(21):1171–1173. doi: 10.1056/NEJM196605262742104. [DOI] [PubMed] [Google Scholar]
  12. Viot M., Joulin C., Cambon P., Krebs B. P., Schneider M., Lalanne C. M. The value of serum alkaline phosphatase alpha 1 isoenzyme in the diagnosis of liver metastases. Preliminary results. Biomedicine. 1979 Jun;31(3):74–77. [PubMed] [Google Scholar]
  13. Winkel P., Bentzon M. W., Statland B. E., Mouridsen H., Sheike O. Predicting recurrence in patients with breast cancer from cumulative laboratory results: a new technique for the application of time series analysis. Clin Chem. 1982 Oct;28(10):2057–2067. [PubMed] [Google Scholar]

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