An unusual alkaline phosphatase isoenzyme associated with gastric carcinoma.
We describe a 50-year-old man with a diagnosis of gastric carcinoma made on gastroscopy after X-rays of the thoracolumbar spine had revealed multiple lytic metastases. A bone marrow aspirate showed adenocarcinoma cells. Polyacrylamide gel electrophoresis incorporating wheat germ lectin was used to separate the serum alkaline phosphatase isoenzymes. Isoenzyme separation showed a markedly increased amount of bone isoenzyme, a normal amount of liver isoenzyme and a considerable amount of an intestinal-like isoenzyme running cathodic to the bone isoenzyme. There was also some immunoglobulin-complexed alkaline phosphatase, which, when digested, showed more of the intestinal-like isoenzyme. This was a variant alkaline phosphatase isoenzyme found in a patient with a gastric carcinoma with a super bone scan. There have been two previous reports of patients with a variant alkaline phosphatase isoenzyme and a super bone-scan.
Jenkins
M A
MA
Division of Laboratory Medicine, Austin & Repatriation Medical Centre, Heidelberg, Victoria, Australia. majenkins@austin.unimelb.edu.au
Steer
C B
CB
Cheng
L W
LW
Ratnaike
S
S
D000469:Alkaline Phosphatase / Q000032:analysis*; D014408:Biomarkers, Tumor; D002277:Carcinoma / Q000201:enzymology*; D006801:Humans; D007527:Isoenzymes / Q000032:analysis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000201:enzymology*
D014408:Biomarkers, Tumor; D007527:Isoenzymes; D000469:Alkaline Phosphatase