Total, free, and acetylated polyamine concentrations were measured simultaneously in colon tissue, serum, and urine of 50 patients with histologically proven colorectal cancer, 40 patients with nonmalignant gastrointestinal diseases, and 30 healthy volunteers. Compared with histologically unaffected colon tissue, concentrations were significantly (P less than 0.001) higher for putrescine, elevated for cadaverine, and nearly identical for spermidine and spermine in colon carcinoma, whereas N1-acetylated and N8-acetylated spermidine were detectable in cancer tissue only. Serum and urine concentrations of all polyamines except total cadaverine and spermine in serum and free spermine in urine were significantly elevated compared with healthy controls and highest sensitivity for colon cancer was found for total spermidine (89.15%) in serum and acetylputrescine (84.5%), total putrescine (84.0%), N1-acetylspermidine (79.3%), and total spermidine (92.1%) in urine. However, nonmalignant gastrointestinal diseases partly showed similar elevations which resulted in a low specificity for polyamines in colorectal cancer. Therefore, polyamines are of little value only as diagnostic markers in colorectal carcinoma. Since polyamine concentrations in serum and urine normalized in patients after curative operation while they were further elevated in patients with proven tumor relapse or metastases, these substances might play a clinical role in predicting therapeutic success or indicating relapse of the tumor. Although a significant dependency of polyamine concentrations in serum or urine to Dukes' classification, tumor localization, CEA, CA 19-9, or CA 125 did not exist, a significant linear correlation was found for tumor size.

We investigated the total, free, and acetylated polyamine concentrations in pancreatic tissue, serum, and urine of 20 patients with pancreatic cancer, 30 healthy volunteers, and 40 patients with nonmalignant, gastrointestinal diseases by reversed-phase liquid chromatography. Tissue concentrations in carcinoma compared to histologically unaffected pancreas were significantly higher for putrescine, elevated for cadaverine, and nearly identical for spermidine and spermine, while N,-acetylspermidine was detectable in cancer tissue only. With the exception of free spermine in urine and total spermine in serum, all other polyamines were significantly elevated in the urine and serum of cancer patients compared to healthy controls. These data support the concept that polyamines play an important role in rapidly growing tissues. However, nonmalignant gastrointestinal diseases partly showed similar elevations. Because of this low specificity, polyamines are of little value only as diagnostic markers of pancreatic carcinoma. Since polyamine concentrations normalized in patients after curative operation while they were further elevated in patients with tumor relapse or metastases, polyamines might play a clinical role in predicting therapeutic success or indicating relapse of the tumor. A significant linear correlation of polyamine concentrations and the size of the tumor was found while a significant correlation to CEA, CA 19-9, and CA 125 or the presence of organ metastases did not exist.

This study was designed to investigate the clinical relevance of polyamine determination in human tissue, serum, and urine as diagnostic markers in the diagnosis or postoperative control of patients with gastrointestinal cancer. Total, free, and acetylated polyamines were measured simultaneously in tissue, serum, and urine of patients with esophageal (n = 16), gastric (n = 40), pancreatic (n = 20) or colorectal (n = 50) carcinoma, in 40 patients with non-malignant gastrointestinal diseases, and 30 healthy volunteers. Though sensitivity of polyamines for gastrointestinal cancer proved to be high, non-malignant gastrointestinal diseases partly showed similar elevated polyamine concentrations in urine and serum which resulted in a low specificity of polyamines for gastrointestinal cancer. Therefore polyamines are not suitable as diagnostic markers in tumor screening. Furthermore, since polyamine concentrations in serum and urine normalized after curative operation while they were further increased and elevated in patients with proven relapse of the tumor or metastases, polyamines might be of clinical value in postoperative monitoring of therapeutical success or predicting relapse of the tumor.

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Total, free, and acetylated polyamine concentrations were investigated in gastric or esophageal tissue, serum, and urine of 40 patients with gastric and 16 patients with esophageal cancer, 40 patients with non-malignant gastrointestinal diseases, and 30 healthy volunteers by means of automated reversed-phase liquid chromatography. In both types of carcinoma polyamine levels were highly elevated in tissue, serum, and urine as compared with healthy controls, which supports the concept that polyamines play an important role in proliferating tissues. However, non-malignant gastrointestinal diseases partly showed similar elevations. A significant linear correlation of polyamines in both carcinomas was found for erythrocyte sedimentation rate but not for tumor stage, tumor size, localization, carcinoembryonic antigen, CA 19-9, and CA 125. It is concluded that owing to its low specificity, polyamine determination in serum and urine has no clinical relevance in the screening for gastric or esophageal carcinoma.