Histochemical studies of alkaline phosphatase in carcinoma of the liver.

Thirty-eight patients who had proven hepatic carcinomas (19 hepatomas, 4 of an unclassified type, 5 cholangiomas, and 10 metastatic carcinomas) were studied. Statistically significant, positive correlations were found between the serum alkaline phosphatase level and the compression effect of carcinoma nodules on the adjoining liver cells, and between the serum enzyme and the sinusoidal phosphatase activity in tissue section. There was no correlation between serum alkaline phosphatase values and serum bilirubin concentration. The seroflocculation tests and iodine test were not significantly abnormal. Neither hepatoma nor metastatic cancer cells took a stain by the calciumcobalt method of Gomori. The elevation of the serum alkaline phosphatase level in carcinoma of the liver most likely is caused by intrahepatic obstruction of biliary channels and a compression effect on the adjoining hepatocytes by carcinoma nodules.