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Endogenous urinary 3-hydroxyproline has 96% specificity and 44% sensitivity for cancer screening.

J Lab Clin Med 1992 Dec;120(6):908-20    (ISSN: 0022-2143)

Okazaki I ; Matsuyama S ; Suzuki F; Maruyama K; Maruta A; Kubochi K; Yoshino K; Kobayashi Y; Abe O; Tsuchiya M
Department of Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan.

A method for determining the endogenous urinary excretion levels of both 3 - hydroxyproline and 4- hydroxyproline that may be useful for cancer screening of the general population and at the workplace is evaluated in this report. The excretion levels of 3 - hydroxyproline and 4-hydroxproline were estimated in 97 patients with cancer and in 99 patients with various nonmalignant diseases and were compared with those of 211 healthy persons. Measurable 3 - hydroxyproline peaks ( by amino acid autoanalyzer) were absent from 93 samples from 211 healthy persons ( 44 %), 50 of 99 patients with nonmalignant disease (50%), and 10 of 96 patients with cancer (10%). The levels of both 3 - hydroxyproline and 4- hydroxyproline in cancer patients were significantly higher than those in healthy persons (p < 0.001 and p < 0.01, respectively) and those in patients with nonmalignant diseases (p < 0.05 and p < 0.01, respectively). Cancer patients were classified into three groups according to grade of cancer growth and invasion. The sensitivity of 3 - hydroxyproline was 44 % and higher than that of 4- hydroxyproline for the detection of stage II cancers (no distant metastasis ); the sensitivities of both hydroxyprolines for the detection of stage I (very early cancer ) were low . The specificity of these assays for healthy persons and patients with nonmalignant disease was 96 % and 92% for 3 - hydroxyproline , and 97% and 79% for 4- hydroxyproline , respectively. Urinary 3 - hydroxyproline level should be further investigated as a cancer screening method for healthy persons in the community or the workplace, but appears unlikely to detect many cancers in the earliest stages.

Comment In : Comment In : RefSource:J Lab Clin Med. 1992 Dec; 120(6):828-30/PMID:1453104