Total, free, and acetylated
polyamine concentrations were measured simultaneously in colon tissue, serum, and urine of 50 patients with histologically proven
colorectal cancer, 40 patients with nonmalignant
gastrointestinal diseases, and 30 healthy volunteers. Compared with histologically unaffected colon tissue, concentrations were significantly (P less than 0.001) higher for
putrescine, elevated for
cadaverine, and nearly identical for
spermidine and
spermine in colon
carcinoma, whereas N1-acetylated and N8-acetylated
spermidine were detectable in
cancer tissue only. Serum and urine concentrations of all
polyamines except total
cadaverine and
spermine in serum and free
spermine in urine were significantly elevated compared with healthy controls and highest sensitivity for
colon cancer was found for total
spermidine (89.15%) in serum and
acetylputrescine (84.5%), total
putrescine (84.0%), N1-acetylspermidine (79.3%), and total
spermidine (92.1%) in urine. However, nonmalignant
gastrointestinal diseases partly showed similar elevations which resulted in a low specificity for
polyamines in
colorectal cancer. Therefore,
polyamines are of little value only as diagnostic markers in
colorectal carcinoma. Since
polyamine concentrations in serum and urine normalized in patients after curative operation while they were further elevated in patients with proven
tumor relapse or
metastases, these substances might play a clinical role in predicting therapeutic success or indicating relapse of the
tumor. Although a significant dependency of
polyamine concentrations in serum or urine to Dukes' classification,
tumor localization, CEA, CA 19-9, or CA 125 did not exist, a significant linear correlation was found for
tumor size.