The role of the radioimmunoassay for prostatic acid phosphatase in prostatic carcinoma.
Considerable controversy exists as to the exact role of prostatic acid phosphatase in the investigation of patients with adenocarcinoma of the prostate. In order to compare different clinical trials, consistent standards of patient selection and staging criteria must be applied on a prospective basis. Other variables which can lead to discrepancies in the results include sources and purification of antigen as well as the analytic accuracy of the immunologic method used. The statistical approach has illustrated the futile outcome of screening an unselected population. On the other hand, if appropriate criteria must be stressed that these estimates have been based on the best possible data available; we have not been able to reproduce either the high sensitivity or specificity reported using three different radioimmunoassays. Therefore, despite the advantages of immunologic methods, we cannot recommend the application of the radioimmunoassay for prostatic acid phosphatase for screening of males for adenocarcinoma of the prostate. At present, no clear explanation can be offered for the elevation of serum prostatic acid phosphatase in patients with apparently localized adenocarcinoma, but it may be of prognostic significance. We have found marked variability in the production of prostatic acid phosphatase by neoplastic acini, and normal levels of prostatic acid phosphatase in patients with metastatic carcinoma may be associated with tumors of limited secretory capacity. Clearly, both the physiologic and methodologic limitations of current radioimmunoassays should be recognized.
D000135:Acid Phosphatase / Q000032:analysis*; D000230:Adenocarcinoma / Q000175:diagnosis* / Q000201:enzymology; D000328:Adult; D000368:Aged; D004796:Clinical Enzyme Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000201:enzymology; D011863:Radioimmunoassay
D000135:Acid Phosphatase