Henneberry M O, Engel G, Grayhack J T
Urol Clin North Am. 1979 Oct;6(3):629-41.
Acid phosphatase is a ubiquitous lysosomal enzyme that hydrolyses organic phosphates at an acid pH. Although the postpuberteral prostatic epithelial cell contains a uniquely high concentration of acid phosphatase, cellular components of bone, spleen, kidney, liver, intestine, and blood also contain this enzyme. The discovery that prostatic carcinoma cells often retain a high concentration of acid phosphatase characteristic of the normal postpubertal gland led to the recognition of the first clinically useful tumor marker. Recognition that the serum of patients with prostatic malignancy frequently contains an increased concentration of this enzyme has resulted in persistent efforts to identify the source, to accurately quantitate the level of serum acid phosphatase, and to determine the clinical significance of those levels. A variety of enzymatic and immunologic techniques have been employed to measure acid phosphatase. In the past, various substrates and inhibitors were utilized to increase specificity and sensitivity. Emphasis has now shifted to the development of radioimmunoassay and counterimmunoelectrophoresis in an attempt to enhance those parameters. Judgment of their efficacy awaits further testing and evaluation. The clinical significance of normal and abnormal serum acid phosphatase is constantly being reevaluated. In order to maximize the value of laboratory measurements, the clinical and pathologic status of the patient, the techniques employed in obtaining and storing the blood sample and the procedures used in analysis must be known and considered. Traditionally, the serum prostatic acid phosphatase has been thought to originate in the prostatic cancer cell and has been used to stage the disease. Until recently, elevated serum values have been accepted as an indication of extraprostatic disease, and were thought to rule out lesions confined to the prostate. The elevation of acid phosphatase levels in patients with disseminated disease or the failure of elevated levels to return to normal with treatment have been assumed to indicate a poor prognosis. However, unequivocal documentation of the validity of these statements is not available. Newer immunologic techniques for measuring acid phosphatase may significantly alter our current concept of its role as a tumor marker.
酸性磷酸酶是一种普遍存在的溶酶体酶，可在酸性pH值下水解有机磷酸盐。尽管青春期后前列腺上皮细胞中酸性磷酸酶的浓度特别高，但骨骼、脾脏、肾脏、肝脏、肠道和血液的细胞成分中也含有这种酶。前列腺癌细胞通常保留正常青春期后腺体特有的高浓度酸性磷酸酶，这一发现促成了首个具有临床实用价值的肿瘤标志物的识别。认识到前列腺恶性肿瘤患者的血清中这种酶的浓度经常升高，促使人们不断努力确定其来源、准确定量血清酸性磷酸酶水平，并确定这些水平的临床意义。已采用多种酶学和免疫学技术来测量酸性磷酸酶。过去，使用各种底物和抑制剂来提高特异性和灵敏度。现在重点已转向放射免疫测定和对流免疫电泳的开发，以试图提高这些参数。对其功效的判断有待进一步测试和评估。正常和异常血清酸性磷酸酶的临床意义一直在重新评估。为了使实验室测量的价值最大化，必须了解并考虑患者的临床和病理状况、采集和储存血样所采用的技术以及分析中使用的程序。传统上，血清前列腺酸性磷酸酶被认为起源于前列腺癌细胞，并已用于对疾病进行分期。直到最近，血清值升高一直被视为前列腺外疾病的指标，并被认为可排除局限于前列腺的病变。已假定播散性疾病患者酸性磷酸酶水平升高或治疗后升高的水平未能恢复正常表明预后不良。然而，这些说法的有效性尚无明确的文献记载。用于测量酸性磷酸酶的更新的免疫技术可能会显著改变我们目前对其作为肿瘤标志物作用的概念。
