Ferritin,
carcinoembryonic antigen (CEA),
beta 2-microglobulin (beta 2-MG) and
prostatic acid phosphatase (PAP) levels in serum from 77 patients with
cancer (6 with
renal adenocarcinoma, 9 with renal pelvic and
ureteral cancer, 29 with
bladder cancer and 33 with
prostatic cancer) at various stages were clinically evaluated for their significance as a parameter of urinary tract
malignancies. Although,
ferritin, CEA and beta 2-MG levels in the poorly-differentiated and advanced stage groups of
renal adenocarcinoma, renal pelvic and
ureteral cancer, and
bladder cancer were higher than those in the well-differentiated and early stage groups, those in most cases were within normal ranges. These
proteins were not considered suitable for the screening test.
Ferritin and beta 2-MG levels increased with advancement of the performance status (P.S.) proposed by Koyama and Saito; however, the latter was affected greatly by renal impairment. In
prostatic cancer, PAP and
ferritin levels were remarkably high in the poorly-differentiated group (PAP mean +/- S.E.: 57.6 +/- 22.5 ng/ml,
ferritin 883 +/- 319 ng/ml) and the advanced stage group (27.2 +/- 10.5 ng/ml, 398 +/- 152 ng/ml) compared to the well-differentiated group (7.87 +/- 3.61 ng/ml, 88.5 +/- 25.8 ng/ml) and the early stage group (2.24 +/- 0.54 ng/ml, 186 +/- 91.7 ng/ml). PAP and
ferritin levels of the untreated cases were positive in 10 out of 18 cases (55.6%) and 7 out of 18 cases (38.9%), respectively, and those of the relapsing cases were positive in 4 out of 7 cases (57.1%) and 6 out of 7 cases (85.7%), respectively. However, CEA and beta 2-MG levels were negative in most cases. Furthermore, increments of PAP and
ferritin levels, especially that of the
ferritin level, were significantly related to advancement of P.S., and high
ferritin levels were obtained in all cases of P.S. 3 and 4. Therefore, determination of PAP and
ferritin seems to be useful in monitoring
prostatic cancer, and the latter to be useful in early detection of relapsing cases.