Significance of preoperational irradiation in the treatment of Wilms' tumor of the kidney (nephroblastoma).
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Biomedical subjects
Publications and source records attributed to V Bek.
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The results of determination of the activity of the liver and bone serum alkaline phosphatase isoenzyme were in complete agreement with the clinical, laboratory and gamma-radiographic findings in all 62 examined patients with neoplastic liver metastases and with the same findings in 36 out of 38 patients with bone metastases. Determination of the bone isoenzyme concurred with the radionuclear findings in 27 out of 30 patients. Thermostable serum alkaline phosphatase variants were evaluated in 136 patients. They were found in 8 out of 40 patients with a lung carcinoma and in 8 out of 13 with a primary hepatocellular carcinoma. The findings were correlated with the presence of alpha-1 fetoprotein in the serum. A thermostable variant corresponding to the Nagao isoenzyme was evaluated biochemically in a patient with a stomach carcinoma.
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In a group of 30 patients with neoplastic processes, 13 were found to have a significantly increased serum alkaline phosphatase activity. This finding correlated with the results of investigation with 85Sr in 7 patients, but owing to a concomitant hepatal symptomatology, it proved of differential diagnostic value in only one of them. On the other hand, the activity of bone isoenzyme of alkaline phosphatase was significantly altered in 15 patients. In 14 of them the increase in bone isoenzyme activity corresponded to an X-ray and a radionuclear finding of a tumor process in the bones. This activity was within the normal range of values in only one patient with a positive result of the 85Sr investigation. An agreement between the results of determination of bone isoenzyme activity of alkaline phosphatase and those of radionuclear investigations was found in 27 patients. In addition, a correlation was established between the increased activity of bone isoenzyme and that of intestinal isoenzyme of alkaline phosphatase. Enzyme investigation can be suitably utilized, alongside radionuclear examination, for early detection of a bone process.
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