Immunohistochemical and biochemical study of alkaline phosphatase in bone tumors and tumorous conditions - With special notes on giant cells.

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Abstract
Immunohistochemical and biochemical investigations were carried out on alkaline phosphatase (ALPase) in 139 patients with bone tumors and tumorous conditions. Biochemically, preoperative serum ALPase level was significantly higher in osteosarcoma and chondrosarcoma, and was significantly reduced postoperatively in osteosarcoma. The ALPase activity in the tumor tissue extract was correlated with the serum ALPase level. All these isoenzymes were considered to be bone type ALPases (ALP3). Liver/bone type ALPase immunostaining was carried out to clarify the following points: 1) Localization of ALPase antigen, 2) differences in stainability between giant cells and small mononuclear cells and 3) relationship of ALPase with calcification by double staining with von Kossa stain. The results were similar to those of enzyme-histochemistry except that stromal cells in the giant cell tumor of bone (GCT) and enchondroma cells were positive for ALPase. Tumorous giant cells were positive in osteosarcoma, but not in GCT and chondroblastoma. Non-tumorous giant cells were all negative. The staining pattern was different between giant cells and stromal cells in GCT, suggesting differences in the origin, differentiation, or intracellular condition between these cells. Differences were present between calcification mediated by osteoid and that in cartilaginous tumors.