A New Enzyme Test for Gynaecological Cancer

6-Phosphogluconate Dehydrogenase Activity in Vaginal Fluid: Limitations as a Screening Test for Genital Cancer

“…We have been able to confirm the findings of Bonham and Gibbs (1962) that 6-phosphogluconate dehydrogenase activity is consistently raised above normal levels in the vaginal fluid of patients with invasive carcinoma of the genital tract. There are, however, serious limitations to the use of the enzyme measurement as a screening test, as half the patients with carcinoma-in-situ do not exhibit increased activity of this enzyme, and there is a high incidence of raised enzyme levels in women without genital cancer.…”

“…Samples of vaginal fluid were collected and 6-PGD activity was determined, using the method of Bonham and Gibbs (1962) modified for a Technicon AutoAnalyzer (Weg and Cameron, to be published). Following Bonham (1963) Stephen's Hospital, London.…”

“…The current practice of examining cells in smears obtained from the vagina and uterus for evidence of cancerous change is of proved value (MacGregor'and Baird, 1963) but some simpler alternative would be welcome. Bonham and Gibbs (1962) and Bonham (1963) have reported encouraging results, using 6-phosphogluconate dehydrogenase activity in vaginal fluid as a screening test for uterine cancer. We have independently carried out this biochemical assay in parallel with standard cytological and histological techniques and this report summarizes our findings in certain well-defined clinical groups.…”

Alcohol intolerance in neoplastic disease.

“…The enzyme changes have been reported in carcinoma-in-situ of the cervix (Bonham Gibbs, 1962) might have some relevance here.…”

Enzymes in Malignant Disease

“…may be increased in the majority of patients with metastases in brain tissue (Wr6blewski et ai, 1958) the increased values also encountered in cerebral inflammatory or vascular disease and the normal values frequent in primary brain tumours renders its determination of little diagnostic help. Vaginal Fluid 6-PGDH elevation is found in a very high proportion (over 95 %) of invasive cancer of the uterine cervix (Bonham and Gibbs, 1962;Cameron and Husain, 1965), however, only 50% of patients with pre-invasive cancer show enzyme elevation (Cameron andHusain, 1965, Hoffman andMerritt, 1965). Increasing experience has shown a much higher incidence of false positives (about 30 % overall) than originally claimed, elevated values being frequent in vaginal bleeding and inflammation, during hormone therapy and after the menopause (Bell and Egerton, 1965).…”