Summary Cellular adhesion molecules have been implicated in tumour progression and metastasis. This study examines for the first time the serum concentrations of circulating VCAM-1 and E-selectin in a consecutive series of 110 cancer patients seen in a general medical oncology clinic, and confirms and extends previous studies reporting measurement of circulating ICAM-1. Soluble ICAM-1 and VCAM-1 levels were significantly higher in all the patient groups compared with the controls whereas soluble E-selectin was significantly higher in the ovarian, breast and GI cancer groups and lower in the myeloma group. The significance of these results together with the possible sources and stimuli for release of these adhesion molecules are discussed.
Sera and patientsBlood samples were obtained from a consecutive series of all patients being seen in a general medical oncology clinic, including those with both localised or advanced disease and those on active therapy or during follow-up. The following malignancies were represented: bladder (n = 6), breast (n = 13), gastrointestinal (n = 18), ovarian (n = 15), renal (n = 12), Hodgkin's disease (n = 15), non-Hodgkin's lymphoma (n = 13), and myeloma (n = 18). Approximately 85% of those with epithelial cancers had clinical evidence of metastases. Samples were allowed to clot, and the serum stored at -70'C until assayed. Samples were also obtained from 89 healthy laboratory and clinical personnel and blood donors (age range 18-60 years) and assayed for E-selectin and VCAM-1. In the case of ICAM-1, a sub-group of 27 of the control samples (age range 24-54 years) were assayed.Assay of soluble adhesion molecules Levels of circulating ICAM-1 were measured with a commercial ELISA kit (British Bio-technology Products, Oxford, UK). Concentrations of circulating E-selectin and VCAM-1 were measured using dual monoclonal antibody two-site ELISAs Pigott et al., 1992). Briefly, microtitre ELISA plates (Nunc Immunoplates, Life Technologies, Paisley, Scotland) were coated overnight with a specific capture antibody (BBIG-E2 for E-selectin, BBIG-V4 for VCAM-1) at a final concentration of 10 tg ml-' in 0.1 M bicarbonate buffer pH 8.9. Standards and samples were added to the plate, incubated for 2 h at room temperature and the bound soluble adhesin of interest was detected by sequential incubation with a specific biotin-labelled antibody (BBIG-E5 for E-selectin, BBIG-V3 for VCAM-1) followed by horseradish peroxidase-conjugated streptavidin (Amersham International, Amersham, UK) and finally tetramethylbenzidine (Universal Biologicals, Kingston-upon-Thames, UK). The reaction was stopped by the addition of 1 M HCI to each well and the O.D. 450 nm measured using a Titertek MS-2 reader (ICN Flow, Rickmansworth, UK). The assays were standardised using a recombinant soluble form of Eselectin or VCAM-1 (Pigott et al., 1991) lacking their transmembrane and cytoplasmic domains and given an arbitrary unitage against which all samples were measured.Statistical analysis Data was analysed using SPSS/PC + . Res...