It is well known that prostatic serum acid phosphatase (PSAP) is elevated in case of prostatic carcinoma with metastasis. Diagnostic value of PSAP for early prostatic carcinoma, however, has not yet been well established. Some doubt is left on the specificity of elevation of this enzyme activity in early prostatic carcinoma. There have been no reports on incidence of elevation of PSAP in noncancerous prostatic diseases.
Numerous investigations have confirmed that serum acid phosphatase activity is elevated transiently by surgical attack, injury, infarction and/or manipulation to normal and abnormal prostatic gland. These facts suggest that elevated PSAP activity may not be specific to carcinoma of the prastate and that it may only indicate presence of various pathological changes of the prostate gland because prostatic acid phophatase is specific to prostatic gland. Therefore, the author make studies to elucidate clinical significance of elevated PSAP activity: 1) relation of changes of the enzyme activity in prostatic tumor tissue and those in serum: 2) relation of these changes and histological features of the prostate: 3) estimation of PSAP activity in 331 patients with various prostatic diseases and 188 normal subjects.
Results are summarized as follows:
1) There are no distinct differences in tissue contents of the enzyme between benign hyper trophy and malignant tumor of the prostate.
2) No relation is noted between PSAP and contents of the enzyme in tissue in the case of adenoma as well as carcinoma of the prostate.
3) Elevation of PSAP was noted in 81.5% of prostatic carcinoma, in 18.0% of non-cancerous prostatic diseases and in 6.3% of normal subjects.
4) In non-cancerous prostatic diseases, elevation of PSAP was shown in 44.4% of benign. prostatic hypertrophy with inflammation, in 25.0% of prostatitis and in 3.6% of benign hypertrophy, with average of 18.0 per cent.
5) In prostatic carcinoma, elevation of PSAP was shown in 73.3% of early carcinoma and. 96.0% of untreated advanced carcinoma.
6) Elevation of PSAP is not specific to prostatic carcinoma, but is noted in various other non-cancerous diseases of the prostate because prostatic acid phosphatase is organ-specific to prostate gland, and its elevation in serum only indicates presence of pathological changes of the prostate gland.
Elevation of PSAP results from translation of the enzyme from prostatic tissue to circulation. Destruction and increase of permeability of glandular cells are among causes of enzyme translation.