Fisken J, Leonard R C, Shaw G, Bowman A, Roulston J E
University Department of Clinical Chemistry, Royal Infirmary, Edinburgh.
J Clin Pathol. 1989 Jan;42(1):40-5. doi: 10.1136/jcp.42.1.40.
A new combined enzyme linked immunoassay (ELISA) was developed to measure both serum placental-like alkaline phosphatase (PLAP) activity (PLAPA) and concentration (PLAPC) in the same microtitre plate using an Imperial Cancer Research Fund monoclonal antibody, designated H17E2. PLAP A and PLAP C were determined together with an existing marker, CA125 in 397 serial samples from 87 patients with epithelial ovarian cancer. Retrospective assessment showed the sensitivity to increase from 73% with CA125 alone, to 88% using CA125 and PLAP A, and to 93% with all three markers in 261 samples from the patients with known active disease at the time of sampling. When the results for all 397 samples were included in the analysis, however, the specificity, sensitivity, accuracy and predictive powers of this monoclonal antibody were not sufficiently high to assist in the prospective follow up of patients with ovarian cancer. This was due to a significant number of false positive and false negative results. Our data indicate that PLAP A or PLAP C estimation with H17E2 may, therefore, only be of value in the management of those patients with known active disease who are already known to be "marker positive" for this antigen.
利用帝国癌症研究基金会的一种名为H17E2的单克隆抗体，开发了一种新的联合酶联免疫吸附测定法（ELISA），可在同一微量滴定板中同时测量血清胎盘样碱性磷酸酶（PLAP）活性（PLAPA）和浓度（PLAPC）。在87例上皮性卵巢癌患者的397份连续样本中，同时测定了PLAP A、PLAP C以及一种现有标志物CA125。回顾性评估显示，在采样时已知患有活动性疾病的261例患者的样本中，单独使用CA125时敏感性为73%，使用CA125和PLAP A时敏感性增至88%，使用所有三种标志物时敏感性达到93%。然而，当将所有397份样本的结果纳入分析时，这种单克隆抗体的特异性、敏感性、准确性和预测能力并不足够高，无法辅助对卵巢癌患者进行前瞻性随访。这是由于存在大量假阳性和假阴性结果。因此，我们的数据表明，使用H17E2测定PLAP A或PLAP C可能仅对那些已知患有活动性疾病且已知对该抗原“标志物呈阳性”的患者的管理有价值。
