LEUKOCYTE ALKALINE-PHOSPHATASE AS A PROBABLE PREDICTOR OF THE METASTATIC STATE IN BREAST AND COLON-CANCER PATIENTS

Leukocyte alkaline phosphatase (LAP) score in peripheral blood was det ermined in 45 new cancer patients, 30 with breast cancer and 15 with c olorectal cancer, with nonmetastatic disease. The LAP scores were perf ormed immediately after diagnosis or surgery, and later at intervals o f 1-3 months, until clinical detection of metastases. The preliminary data presented here show that there may be some utility in measuring L AP score in patients with solid tumors on a serial basis to detect evi dence of metastatic disease prior to its clinical recognition. In 22 o ut of 30 breast cancer patients and 11 out of 15 colon cancer patients , there were 'alarming signals' of metastases (defined in this study) in the data taken before the checkup in which metastases were diagnose d by other methods. We conclude that LAP scores should be introduced i nto routine checkup of breast and colon cancer patients and could be a helpful nonspecific additional element in detecting earlier metastati c disease during the follow-up of a patient. As an extrapolation from this study we suggest that work should be undertaken to explore the po ssibility that a sudden rise of LAP score in an otherwise healthy pers on, who has no known reason for an elevated LAP score, might be the ve ry first measurable sign of cancer.