A variant alkaline phosphatase (ALP), with heat-sensitivity characteristics similar to that of the bone type, was found in the serum of a patient suffering from lung cancer. In disc polyacrylamide gel electrophoretic studies most of this enzyme had migrated to the region corresponding to liver ALP, with the remainder affecting bone ALP. Like kidney ALP, this ALP was markedly inhibited by 0.5 mmol/1 L-cysteine. The K(m) of this ALP for p-nitrophenylphosphate was 0.39 mmol/1, similar to that of kidney ALP. The sugar moiety of this enzyme bore greater resemblance to that of kidney ALP than liver or bone ALP. However, immunoprécipitation of this particular ALP was strong with a monoclonal antibody against liver ALP and moderate with an antibody against bone ALP.

A 40-year-old woman had been treated with low anterior resection for rectal cancer nine years before, and with left upper lobectomy for lung metastasis of the cancer three years before. Since around four months before, the serum level of carcinoembryonic antigen started to elevate gradually, and the mass in the left chest wall was noticed. En-block resection of the chest wall including three ribs and a part of the lung was performed, and a large defect after wide resection of the chest wall was reconstructed with marlex mesh which was used as a prothetic material. The post-operative course was quite uneventful. She complained of neither paradoxical movement of the chest wall nor foreign body reactions postoperatively. The mass was diagnosed as metastasis of the rectal cancer, histologically. Eight months after discharge, multiple metastases in her both lung were noticed. The patient was admitted again and now in the treatment with immunochemotherapy.

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