Monoclonal antibody assay of serum placental alkaline phosphatase in the monitoring of testicular tumours

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Abstract
A monoclonal antibody (H17E2) recognizing both placental alkaline phosphatase (PLAP) and testicular PLAP-like alkaline phosphatase was incorporated in a solid phase immunoassay. This was used to measure levels of PLAP in 257 sera from 148 patients with germ cell neoplasms of the testis. High levels of PLAP were found in all patients with active seminomas (mean 0.85 O.D. [outer diameter]), compared to those in clinical remission (mean 0.20 O.D.) (P < 0.0001). More importantly, changing levels of PLAP correlated with the course of disease in 79 samples from 33 patients with seminoma (P < 0.0001). Elevated PLAP levels were also noted in patients in remission who were smokers (mean 0.32 O.D.) compared to nonsmokers (mean 0.15 O.D.) (P < 0.001). Determination of PLAP levels using this sensitive immunoassay is apparently an important new adjunct in the monitoring of the response to treatment in patients with seminoma.