Nicholls D P, Davies J S
Thorax. 1977 Aug;32(4):472-7. doi: 10.1136/thx.32.4.472.
, , 472-477. Two cases are presented in which an undifferentiated small-cell carcinoma of the bronchus was associated with a considerably raised serum tartrate-labile acid phosphatase concentration. In neither case was there any evidence of a carcinoma of the prostate which, with a few rare exceptions, is the only condition associated with such increased enzyme activity. A survey of acid phosphatase concentrations in 30 other male patients with carcinoma of the bronchus showed that five patients had a raised total acid phosphatase concentration, but only one patient had a raised tartrate-labile acid phosphatase concentration. When the histological type was taken into account, elevated total acid phosphatase concentrations were associated with squamous-cell and adenocarcinoma but not with undifferentiated, small-cell carcinoma. Raised tartrate-labile acid phosphatase concentrations were associated only with squamous-cell carcinoma, in contradistinction to the two individual cases reported. In no group was there any correlation between acid and alkaline phosphatase concentrations. Histological studies in one of our patients showed little tissue acid phosphatase staining in the primary tumours but intense staining in the cytoplasm of pancreatic cells surrounding a metastasis. Sections of pancreas from six normal subjects showed only slight tissue acid phosphatase activity. The possible sources of the increased serum acid phosphatase are discussed, and it is suggested that the pancreas could be the source of such increased activity in our second case.
本文报告了2例支气管未分化小细胞癌患者,其血清酒石酸不耐受酸性磷酸酶浓度显著升高。在这两例中,均未发现前列腺癌的证据,而前列腺癌是唯一与这种酶活性增加相关的疾病,仅有少数罕见例外情况。对另外30例男性支气管癌患者的酸性磷酸酶浓度进行调查发现,5例患者的总酸性磷酸酶浓度升高,但只有1例患者的酒石酸不耐受酸性磷酸酶浓度升高。考虑组织学类型时,总酸性磷酸酶浓度升高与鳞状细胞癌和腺癌相关,而与未分化小细胞癌无关。与所报告的2例个体病例不同,酒石酸不耐受酸性磷酸酶浓度升高仅与鳞状细胞癌相关。在任何一组中,酸性和碱性磷酸酶浓度之间均无相关性。对我们其中1例患者的组织学研究显示,原发性肿瘤中组织酸性磷酸酶染色较少,但转移灶周围胰腺细胞的细胞质中染色强烈。6例正常受试者的胰腺切片仅显示轻微的组织酸性磷酸酶活性。文中讨论了血清酸性磷酸酶升高的可能来源,并提出在我们的第二例病例中,胰腺可能是这种活性增加的来源。