The significance of the blood acid and alkaline phosphatase values in cancer of the prostate.

Acid Phosphatase On each of the 500 patients the total plasma acid phosphatase and its formaldehyde stable fraction were estimated, the latter by the method described by Abul Fadl and King (1948), with results as shown in Table II. In this the unit values to the left of the centre dark line are within the normal range whilst those on the right are in the "doubtful " or " prostatic cancer" groups. It will be seen from the lower part of section A that, with the estimation of the total value in those cases without prostatic cancer, 14 gave misleadingly raised results, but by estimating its formaldehyde stable fraction as shown in section B this figure became 8. These findings suggest that the latter test is a more reliable clinical guide in the investigation of "prostatic" conditions, as claimed by Abul Fadl and King (1948). The eight patients who had a raised formaldehyde stable fraction were further investigated and urinary retention was found to have been present in all when the first estimation was made. It will be seen from section C that, when this test was repeated following relief of the retention, its value fell to normal in all but one case. This patient had carcinoma of the bladder infiltrating the prostate and periprostatic tissue and was differentiated from prostatic cancer on both clinical and histological examination Thus, when the formaldehyde stable fraction of the acid phosphatase was estimated on blood taken after urinary retention had been relieved and