STUDIES OF CHOLINESTERASE ACTIVITY. V. SERUM CHOLINESTERASE IN PATIENTS WITH CARCINOMA

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Abstract
Human patients with carcinoma exhibit depression of serum cholinesterase (pseudocholinesterase) activity which is more marked in groups with metastatic rather than local disease. A study of 208 subjects revealed that this does not depend primarily upon hepatic parenchymal involvement by tumor cell invasion or biliary tract obstruction and is only partially related to depression of serum albumin levels in these patients or their general physical condition. Carcinoma patients had lower enzyme values than did equally ill patients with benign diseases, and patients with metastatic carcinoma had lower enzyme values than did equally ill patients with local tumor. Accuracy was 83% in predicting a benign or malignant lesion as the cause of obstructive jaundice in a series of 60 patients. The site of origin of the carcinoma exerted some influence on enzyme activity. It is postulated that carcinomatous tissue produces or activates an inhibitor to serum cholinesterase. Determination of serum cholinesterase is a useful adjunct to other clinical methods of detecting the presence of carcinoma and determining its degree of spread in individual patients. It has potential usefulness in assaying the effect of therapy of cancer.