[Role of prostatic acid phosphatases in the treatment of adenocarcinoma of the prostate].

On the basis of a series of 89 patients with a histologically confirmed adenocarcinoma of the prostate and another population of 89 patients with prostatic hypertrophy, also confirmed histologically, the authors study the sensitivity and specificity of the radio-immunological estimation of prostatic acid phosphatase levels. Comparison is made of the performance of radio-immunological techniques with that of conventional techniques. As a general rule, the sensitivity of the test is very low, since amongst 39% of the prostatic carcinomas studied, the RI acid phosphatase level was below the upper limit of normal fixed at 3.2 ng/ml. By contrast, the degree of specificity is high, since amongst 96% of cases with abnormally high RI acid phosphatase levels, the diagnosis was indeed an adenocarcinoma of the prostate. In terms of stages, sensitivity was found to be nil for minor stages T1 - T2 and of the order of 80% for advanced stages. This confirmed data from the literature. In the absence of bone metastases detectable radiologically or by isotope bone scan, an abnormally high RI acid phosphatase level is predictive of lymph node involvement in 90% of cases. By contrast, under the same conditions of bone investigations, a normal RI acid phosphatase level corresponds in 81% of cases with absence of lymph node involvement and in 19% with limited involvement. In patients with value which are normal or become normal under the influence of treatment, the prognosis is better than if such does not apply. Finally, figures given by radioimmunological estimation are much more specific than those obtained by traditional enzyme estimations.