CHANGES IN SERUM HAPTOGLOBIN IN PATIENTS WITH RENAL CELL CARCINOMA

Abstract

The authors have examined levels of and changes in serum haptoglobin in 33 cases with renal cell carcinoma. Immunoelectrophoresis and the single radial immunodiffusion method were used to clarify the ability of serum haptoglobin to detect the said carcinoma.
Results obtained were as follows:
1) The mean with standard deviation of concentration of serum haptoglobin from the 33 cases was 317±199mg/dl, 28 were above the normal mean. A remarkable rise in haptoglobin level was found in patients with advanced cancer.
2) Haptoglobin phenotypes in the immunoelectrophoretic patterns were: 4 cases of Hp1-1, 9 cases of Hp2-1 and 17 cases of Hp2-2. Serum haptoglobin phenotype distribution was normal. The mean serum haptoglobin concentration with standard deviation in each phenotype was 402±219mg/dl. in Hp2-2, 376±163mg/dl, in Hp2-1 and 230±114mg/dl. in Hp1-1.
3) A close relationship was found to exist between α₂-globulin and serum haptoglobin. Increases in α₂-globulin in renal cell carcinoma resulted from increases in haptoglobin. In a few cases, however, no increases in α₂-globulin occurred despite an increase in haptoglobin.
4) The levels and changes in ceruloplasmin, α₂-macroglobulin and α₂-HS glycoprotein in the α₂-fraction were determined simultaneously with those of haptoglobin. The mean and standard deviation of ceruloplasmin was 36±12mg/dl; that of α₂-macroglobulin was 189±50mg/dl, while that of α₂-HS glycoprotein was 46±13mg/dl. Increases in ceruloplasmin and decreases in α₂HS and α₂M were observed in patients with advanced cancer.
5) Serum haptoglobin levels showed a definite increase in renal cell carcinoma in comparison with various other urological disorders.
6) A remarkable increase in serum haptoglobin was found in patients with fever, raised ESR, anemia and CRP positive. In patients without these symptoms, on the other hand, haptoglobin showed only a slight increase. No correlations were found between haptoglobin and white blood cells, between haptoglobin and cell types, or between haptoglobin and liver functions.
7) There was a definite correlation between serum haptoglobin and staging, and also between haptoglobin and survival rate. Patients with localized renal tumors had normal serum haptoglobin levels and experienced slight increases in haptoglobin. Patients with renal capsule invasion experienced a remarkable increase in haptogloibn. Patients with demonstrable distant metastasis exhibited abnormally elevated haptoglobin levels.
8) Prognosis was generally poor in patients with elevated haptoglobin levels. Patients with metastasis showing definite increases in haptoglobin had very poor prognoses.
9) Patients in good postoperative clinical condition exhibited normal serum haptoglobin levels. Elevated serum haptoglobin levels were noted in patients whose clinical evidence betrayed recurrence.
Serum haptoglobin may be helpful in early detection of renal cell carcinoma recurrence in patients who have been operated upon. Serum haptoglobin increased somewhat, particularly in those patients with renal cell carcinoma and helped us to define the state of the said carcinoma. It is concluded that the determination of serum haptoglobin has a practical use in the evaluation of clinical conditions, in preoperative staging, in prognosis and in the detection of metastasis.