Acute-phase reactant proteins and complement components and inhibitors in patients with ovarian cancer

Serum alpha 1-acid glycoprotein in epithelial ovarian cancer

Fifty-six patients with ovarian adenocarcinoma receiving chemotherapy were monitored with serum alpha 1-acid glycoprotein (AGP) levels. The mean and standard deviation of serum AGP levels for 63 healthy controls were 0.88 +/- 0.469 mg/ml. A serum level above 1.80 mg/ml was considered as above normal level. Five patients had evidence of persistent ovarian carcinoma and had elevated AGP levels. Sixteen patients had normal serum AGP levels and had no evidence of persistent ovarian cancer at second-look laparotomy. However, 35 patients had false-negative AGP levels at the time they had persistent tumor. Although the specificity of the AGP level was 100%, the sensitivity was only 12.5% and the overall accuracy 37%. Therefore, it would appear that serum AGP levels are not of value in monitoring patients with ovarian adenocarcinoma.

Serum-mediated immunosuppression: a possible tumor marker in patients with ovarian carcinoma

Serum samples from 25 patients with ovarian carcinoma were tested for their suppressive effects on in vitro response of normal lymphocytes. Patients examined prior to primary surgery showed a significantly greater suppression than did patients examined after a radical operation. Suppression was detected both in a natural killer cell assay and in an assay of phytohemagglutinin-induced lymphoproliferation. Only the results of the later test showed a correlation to the clinical course: Those patients who died during the first year of follow-up presented the most marked suppression. Serial determinations performed in a few patients indicated a certain correlation between immunosuppression and tumor burden. It is concluded that this test may give additional prognostic information in patients with ovarian carcinoma.

Serum haptoglobin and alpha 1-acid glycoprotein as indicators of the effectiveness of cis-diamminedichloroplatinum (CDDP) in ovarian cancer patients--a preliminary report

Twenty-one patients with adenocarcinoma of the ovary were given a maximum of five courses of CDDP by i.v. infusion every 4 weeks. With one exception, the serum levels of both haptoglobin and alpha 1-acid glycoprotein correlate with tumour burden before therapy and at follow-up. It is suggested that a more accurate assessment of the effectiveness of CDDP therapy may be obtained by estimating these serum proteins before each infusion than by an abdominal examination.

Changes in serum acute phase proteins in ovarian cancer patients receiving cis-diamminedichloroplatinum (CDDP) infusion therapy

Nine patients with adenocarcinoma of the ovary were given a number of courses of Cisplatin, by I.V. infusion. In four patients a complete clinical response was observed and these patients are disease-free one year after treatment. There was no clinical response in the remaining five patients who have subsequently died. Serial determinations of three acute-phase reactant proteins (alpha 1-acid glycoprotein, haptoglobin, alpha 1-antitrypsin) were performed before every infusion and after therapy. Constantly high or rising serum levels of haptoglobin and alpha 1-acid glycoprotein were associated with progression of the cancer, whereas in patients who were disease-free after therapy, these glycoproteins remained essentially in the normal range. The results suggest that serial measurements of haptoglobin and alpha 1-acid glycoprotein may have clinical value as aids in deciding the effectiveness of drug therapy in these patients.

The effect of surgery and chemotherapy on blood NK cell activity in patients with ovarian cancer

The cytotoxic activity of NK cells in peripheral blood was studied in 15 patients with ovarian cancer Stage III and IV before and after surgery and ten-week intramuscular therapy with thiotepa. An evident decrease in NK activity was found 24 hours after surgery, with a slow return toward normal values within 7-9 days. No differences between patients with explorative laparotomy and with extirpation of the tumor were observed. The mechanism of the decreased NK cytotoxicity remains unknown but there was a concomitant reduction in the number of blood mononuclears. A second drop in NK activity occurred after chemotherapy. It was most likely due to the drug bone marrow depression. No evident correlation between the reduced NK activity and advancement of the disease could be found.