Biomedical subjects
Publications and source records attributed to E H Cooper.
Sex Hormone Binding Globulin (SHBG) was measured in 130 patients with carcinoma of the prostate. Its level is raised in patients treated with oestrogen and it is possible that this may be of prognostic significance. The possible relevance of SHBG in oestrogen-treated patients is discussed.
A profile of acute phase reactant proteins has been studied in patients with cancer of the prostate as an aid to diagnostic staging and therapy control. A linear discriminant function analysis incorporating serum acid phosphatase, prealbumin, alpha1 antitrypsin, alpha1 acid glycoprotein and haptoglobin allows the correct identification of metastatic disease in 88.6% of patients. The profile may also serve to augment other parameters in the assessment of the physiological effect of oestrogen treatment and show whether the prescribed medication is being taken.
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The levels of haptoglobin, alpha1 antitrypsin and alpha1 acid glycoprotein are moderately raised in chronic leukaemias. In CGL the level of haptoglobin and acid glycoprotein show the highest correlation with cell number, whilst no such correlations occur in CLL or CMML. There does not appear to be a relation between blood lysozyme levels and the levels of antiprotease (alpha1 antitrypsin and alpha2 macroglobulin).
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The alpha1 and alpha2-globulins have been studied at various stages in the evolution of colo-rectal cancer. The alph2 was elevated in some primary tumours and rose in metastatic cancer especially when it involved the liver. Some apparently tumour free patients had an unexplained elevation of alph2-globulins. The macroglobulins were not a major constituent of the raised alpha2-globulins. Haptoglobulin levels were found to be a useful indicator of tumour activity, when their level was raised in metastatic cancer it was usually with an antecedent or coincidental rise of plasma CEA. Primary tumours may cause a high haptoglobin response without an elevation of CEA.
The long term administration of dimethylhydrazine to mice induces severe hepatotoxic damage. Parenchymal cell pleomorphism and necrosis were later associated with reticulin collapse and bile duct proliferation. Withdrawing the drug after 17 weeks was followed by some improvement in the parenchymal cells but there was a chronic proliferative response tending towards early cirrhotic changes. The rats appeared relatively resistant to the hepatotoxic effects but unlike the mice the colon tumors arising in these animals bled frequently and could result in profound anemia.
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The evolution of metastatic colorectal cancer in patients who have had surgical treatment for a primary lesion was studied in relation the progressive changes in the blood levels of carcinembryonic antigen (CEA), to gamma glutamyl transpeptidase (GGT) and routine liver function tests (LFTs). Involvement of the liver could ofter be reliably predicted many weeks in advance of clinical diagnosis while metastases to other sites were less likely to be detected early by this test. The association of the extent of disease with the patterns of biochemical changes is discussed with reference to several illustrative examples.
Serial estimations of plasma carcinoembryonic antigen (C.E.A.) levels have been carried out in 220 patients with colorectal carcinomas who had potentially and apparently curative surgery. In a two-year follow-up period 53 patients developed recurrences or metastases. In 36 of these patients sustained rises in plasma C.E.A. titres occurred synchronously with or between three and 18 months before the clinical detection of recurrences or metastases. The use of serial plasma C.E.A. assays is therefore recommended as an additional diagnostic aid for the earlier detection of recurrent or metastatic colorectal carcinomas.
The serum muramidase levels were measured in 128 patients with primary or metastatic colorectal cancer, 166 tumour-free patients after resection of a colorectal cancer, and 172 controls. Muramidase levels over 10 mug/ml were detected in 30%-39% of the tumour-bearing patients, in 8.2% of the tumour free, and in only 1.7% of the controls (normal level 6.68 +/- 1.42 mug/ml). Long-term follow up indicated that raised levels may occur as a transient phenomenon in recurrent or metastatic disease. The likely relation of abnormal serum muramidase activity and stimulation of the reticuloendothelial system is discussed.
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Plasma CEA values and serum γ glutamyl transpeptidase activities have been compared in control subjects and 109 patients with colorectal carcinoma and 35 with non-malignant hepatic disease. CEA values alone differentiate hepatic metastases from non-malignant hepatic disease with a high degree of certainty. While CEA may be elevated with metastases, irrespective of site, γGT is elevated mainly in association with hepatic metastases. The combination of CEA and γGT is helpful in identifying hepatic metastases and in their differentiation from local recurrences or metastases to other sites.