Determination of TPA levels in breast cancer and controls

Abstract

The clinical significance of radioimmunological determination of Tissue Polypeptide Antigen (TPA) has been studied on patients with breast cancer (n = 376), on "normal subjects" (n = 92), on benign diseases of the breast as well as on patients with inflammatory diseases (n = 98). TPA levels were elevated (120 U/l or higher) in the group with inflammatory diseases in 68% and in the group with breast cancer (stage IV with progression of disease) in 85%. In all other groups (healthy controls, benign diseases of the breast, breast cancer before operation, breast cancer stage I (NED), breast cancer stage II and III (NED), and breast cancer stage IV (PR/CR), TPA was higher only in 5-22%. TPA determinations seem not to be very useful for diagnostic purposes in breast cancer, but it can be regarded as suitable for monitoring proliferative processes in advanced breast cancer. Limitations result from lack of tumor specificity of the proliferation marker TPA. So far, follow-up studies after mastectomy in breast cancer and in patients with advanced breast cancer under chemotherapy have shown that CEA and TPA are concordant. There is no cross reactivity between CEA and TPA. The main component of the labeled tracer has an isoelectric point of 4.4 but there is some impurity in the tracer as it was shown in chromatofocusing.

Determination of Tissue Polypeptide Antigen (TPA) Levels in Different Cancer Types and Controls

“…This was shown in breast cancer patients [9,13], in patients with ovarian malignancies [32] and in patients with gastrointestinal and genitourinary can cers. In about 80% of these cases, TPA and CEA showed almost parallel increase and decrease.…”

“…The tumor load at the time of TPA determination was rather high. Perhaps there might be a correlation between tumor load and TPA level, because in the group of breast cancer patients stage T i and Ti only 22% of all persons showed elevated TPA levels preoperatively [13,14]. Not only the tumor load seems to be important for the interpretation of el evated TPA levels, but also the rate of tumor growth.…”

“…18, 35]. In our first study of TPA levels in breast cancer patients [13], we concluded that it is possible to differentiate in about 80% between progression (P) and regression of tumor growth in advanced breast cancer. In the present series of TPA determinations, we investigated patients with cancer in different organ sites.…”

Ergebnisse mit dem Tissue Polypeptide Antigen (TPA) und Plasma-TPA-Werte im postoperativen Verlauf bei primären Mammakarzinompatientinnen

“…Es liegt zu diesem Zeitpunkt bereits eine beachtliche Anzahl von wissenschaftlichen Mitteilungen zum TPA vor, wobei insbesondere die Verwendung des Proli ferationsmarkers als Tumormarker Inhalt der meisten Veröf fentlichungen war [1,5, 7,10,12,18-21,23-32, 35-38, 42-44], Die bisher umfangreichsten publizierten Untersuchungsserien wurden von Björklund et al [1] mit 1483 Untersuchungen und von Mross et al [25] mit 1175 Untersuchungen vorgelegt. TPA-Ergebnisse bei nichtmalignen Erkrankungen liegen ebenfalls für Autoimmunerkrankungen [34], nicht maligne Erkrankungen der Mamma [44] und Arbeitern, die Karzino genen ausgesetzt waren [14], vor, wie auch biochemische und proteinchemische Analysen des TPA erfolgt sind [16,17,26,33,40]. Auch erste immunhistologische Arbeiten sind publi ziert worden [2,3,6], so daß seit der Vorstellung des TPARadioimmunoassays 1979 durch Wiklund et al [41], der die Hämagglutinationstechnik ablöste, innerhalb von vier Jahren ein relativ großes Datenmaterial vorliegt.…”