N1,N12-diacetylspermine (DiAcSpm) and N1,N8-diacetylspermidine (
DiAcSpd) are minor components of human urinary
polyamine to which little attention has been paid until recently. HPLC analysis of urinary
polyamines has revealed that the excretion of these diacetylpolyamines, in particular, into urine was frequently and markedly increased in association with every type of
cancer so far examined. Remission was usually accompanied by recovery of urinary diacetylpolyamines to the normal level. DiAcSpm was more sensitive than CEA for detecting
colorectal cancer patients, while
DiAcSpd was highly specific for malignant conditions in that the excretion of the latter was scarcely elevated in cases of benign
urogenital diseases. An ELISA procedure for rapid determination of DiAcSpm was developed to promote the clinical application of these new
tumor markers, and subsequent studies indicated that DiAcSpm was elevated in 60% of
colorectal cancer patients at early stages (stage 0 + I), whereas only 10% of these patients were CEA-positive. DiAcSpm may also be useful as a follow-up marker that is efficient for detecting recurrence and sensitive to changes in the clinical condition of patients. The evidence accumulated so far indicates that DiAcSpm and
DiAcSpd are promising novel
tumor markers. They deserve more intensive studies, including studies of their biochemistry and metabolism.