Although morphologic identification of cancer on histologic microsections is considered essential to diagnosis of malignancy, the biochemical examination of body fluids and tissues has supplemented and extended pathologic information. In fact, the borderline areas of hyperplasia and true neoplasia may be defined in this manner. As Utz and Farrow concluded, prognostication will probably increase in accuracy not by refinement of morphologic criteria, but by research in enzymology and histochemistry. If their specifity increases, such procedures may ultimately supplant the need for tissue diagnosis and may guide response to treatment.
Interest in body-fluid enzymes in malignant neoplasia has resulted in recent studies in acid phosphatase, alkaline phosphatase, aminopeptidase, LDH, glutathione reductase, ribonuclease, amylase, ulodase, phosphoglucomatase, and phosphohexose isomerase.69 This is not an exhaustive list, but it reflects current pursuits in cancer enzymology. The basic concepts elaborated by Greenstein69 are that each tissue has its own enzyme profile as an