Evaluation of Carcinoembryonic Antigen, Tissue Polypeptide Antigen, Placental Alkaline Phosphatase, and Modified Nucleosides as Biological Markers in Malignant Lymphomas

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Abstract
Elevated levels of biological markers for cancer in various body fluids can play a role in diagnosis and in assessment of response to treatment. In recent years several new substances have been evaluated as biological markers. The usefulness of carcinoembryonic antigen (CEA) as a marker for cancer in the gastrointestinal tract as well as in other malignant conditions has been established (Bacchus 1977). However, other markers are still in the process of evaluation. Modified nucleosides in the urine have been evaluated as biological markers for different types of cancer, and some positive correlations have been observed by Waalkes and Borek (1975), Schöch and Heller-Schöch (1977), and Gehrke et al. (1979). During these early studies the analytical methods used were cumbersome and not suitable for routine analysis. However, with the recent development of high-performance liquid chromatography (HPLC), fast methods with great precision have been presented (Gehrke et al. 1978), and a more extensive study of the clinical use of modified nucleosides as biological markers can therefore be performed. Tissue polypeptide antigen (TPA) and placental alkaline phosphatase (PLAP) are proteins in the serum which may serve as markers in different malignant diseases (Björklund 1980; Holmgren et al. 1978). The aim of the present study was to evaluate the above-mentioned tumor markers individually and together in relation to tumor burden and stage of disease in a series of 63 patients with three different kinds of malignant lymphoma. The different types of biological markers assessed in this study are presented below in more detail.