Development of oxygen insensitivity of the quantitative histochemical assay of G6PDH activity during colorectal carcinogenesis.

The effects of oxygen on the quantitative histochemical assay to detect glucose-6-phosphate dehydrogenase (G6PDH) activity based on neotetrazolium reduction were studied in the different stages of carcinogenesis in the colon. Normal and hyperplastic epithelium, mucosae of patients with active Crohn's disease, and adenomas and adenocarcinomas of the colon were used. Epithelium of normal and inflamed mucosa, and hyperplastic epithelium, showed a residual G6PDH activity (RA) in oxygen that was always less than 20 per cent of the activity in the absence of oxygen. In adenomas and in dysplastic epithelia adjacent to carcinomas, the RA was significantly higher than that in normal epithelium, but significantly lower than that in adenocarcinomas. The RA of adenomas never exceeded 35 per cent. The RA of adenocarcinomas was on average 53 per cent and always higher than 20 per cent. When 35 per cent was used as a cut-off level, the sensitivity of RA to diagnose malignancy was 96.5 per cent. In a parallel study, a mouse model was used in which colon carcinomas and their precursors were induced chemically. Development of oxygen insensitivity during chemically induced carcinogenesis showed a pattern similar to that observed in the human. In conclusion, the test to determine RA is a useful tool for the detection of malignant mucosa in the colon. The test is particularly helpful in addition to histopathology for the detection of small lesions and the early stages of cancer.