MONOCYTE ESTERASE DEFICIENCY IN GASTROINTESTINAL CANCER

Aims-To substantiate the high incidence of monocyte esterase deficienc y (MED) in gastrointestinal carcinoma already reported in a small grou p o patients; to compare the clinical findings in esterase deficient a nd esterase positive patients. Methods-Peripheral blood smears (n = 22 ) or cytocentrifuge preparations (n = 52) of mononuclear cells from th e peripheral blood of patients with gastrointestinal carcinoma were st ained by the non-specific esterase stain (pH 5.8) using a batch techni que. Samples containing greater-than-or-equal-to 85% esterase negative monocytes were identified at light microscopic examination. Results-S even of 74 patients were identified as having MED. This correlated exa ctly with the proportion (five of 46) found before, using an automated method, and was significantly higher than the 0.8% incidence in norma l blood donors shown in that study. Comparison of the clinical details of the 12 MED patients with those of 105 esterase positive patients s howed a significantly longer disease free survival in the MED cohort a nd increased occurrence of benign neoplasms-largely colorectal polyps- in this group also. Three patients had a borderline degree of deficien cy and were excluded from comparisons, although they showed the same c linical tendencies as the MED group. Conclusions-There is a strong deg ree of association between monocyte esterase deficiency and gastrointe stinal carcinoma. Further evidence must be sought to prove that the de ficiency precedes the disease and therefore may predispose to it, or a t least may identify subjects with such a predisposition. This could l ead to early diagnosis and effective treatment of gastrointestinal car cinoma in a sizeable proportion of patients.