Clinical significance of acid phosphatase

Acid phosphatase is a substance that is widely present in human tissues, mainly in cells and body fluids. The acid phosphatase in the blood mainly comes from the prostate, platelets, white blood cells, etc., among which the content is most abundant in the prostate. In daily medical examinations, the examination of acid phosphatase can serve as an auxiliary diagnosis for prostate cancer. It also has a certain diagnostic function and effect on blood diseases and bone diseases.

Clinical significance

Acid phosphatase in normal human serum is derived from bone, liver, kidney, spleen, pancreas and other tissues, so its content is roughly the same regardless of gender, age or status. The activity of acid phosphatase in the serum will increase in patients with prostate disease, hepatitis, hyperparathyroidism, red blood cell disease and other diseases. In order to identify whether the increased acid phosphatase in the serum comes from the prostate or from other organs, it is necessary to distinguish. To this end, certain inhibitors can be further used to achieve selective inhibition. For example, ethanol and tartaric acid have a significant inhibitory effect on prostatic acid phosphatase, but a weaker inhibitory effect on erythrocyte acid phosphatase.

ACP determination is mainly used for auxiliary diagnosis of prostate cancer.

(1) Prostate cancer: ACP is significantly increased, especially in metastatic cancer. PAP is more sensitive than ACP in diagnosing prostate cancer, and both are more valuable in diagnosing advanced prostate cancer, observing therapeutic effects, and monitoring prognosis.

(2) Blood diseases: ACP activity is also increased in myeloid leukemia, Gaucher's disease, Niemann-Pick's disease, idiopathic thrombocytopenic purpura, hemolytic anemia, etc.

(3) Non-malignant prostate diseases: ACP activity is also increased in prostatitis, prostatic hypertrophy, prostatic infarction, etc.

(4) Bone diseases: ACP activity may also be elevated in osteitis deformans, osteogenesis imperfecta, rickets, osteosarcoma, multiple myeloma, and bone metastases of certain non-prostate malignant tumors.

(5) Others: ACP activity may increase in conditions such as hyperthyroidism, acute or chronic nephritis, and urinary retention.

One-third to one-half of the acid phosphatase in normal male serum comes from the prostate, while the acid phosphatase in female serum mainly comes from the liver, red blood cells and platelets. There are 20 isoenzymes of acid phosphatase, and the isoenzymes measured clinically can be roughly divided into two categories: one is prostatic acid phosphatase; the other is non-prostatic acid phosphatase. Acid phosphatase assay is mainly used for auxiliary diagnosis of prostate cancer.