An enzyme-linked immunosorbent assay for cancer procoagulant and its potential as a new tumor marker.

Abstract

Cancer procoagulant (CP) is a Mr 68,000 cysteine proteinase that initiates blood coagulation and is expressed by a variety of malignant cells but not by normally differentiated cells. Polyclonal immunoglobulin G and monoclonal immunoglobulin M antibodies were developed to purified CP and used to develop an enzyme-linked immunosorbent assay to analyze the antigen in human serum samples. The purpose of this preliminary study was to determine whether or not the analysis of CP in the serum might be a useful tumor marker. Pure CP was added to normal serum to establish a quantitative standard curve; the correlation coefficient of seven standard curves was 0.99. The upper limit of the normal range was established with 46 normal sera (mean +/- 2 SD = 0.57 microgram/ml). A total of 128 blinded serum samples were analyzed: 54 were from cancer patients (29 with gastrointestinal cancer, 22 with lung cancer, and three with urogenital cancer); 20 were from benign disease patients; and 54 were from normal individuals. All of the 13 early stage cancers were greater than 0.57 microgram/ml (positive), 31 of 41 (76%) of the late stage cancers were positive; overall, 44 of the 54 cancers (81%) were positive. Forty-nine of 54 (91%) of the normal sera and 16 of 20 (80%) of the benign disease sera were negative. Overall, the assay had a sensitivity of 81% and a specificity of 88%.