Abstract Malignant melanoma, a disease that is increasing in occurrence and medical concern, is characterized by the excretion of melanogens. Two qualitative tests are recommended for melanogen detection, the Thormählen test and the ferric chloride test. We evaluated the laboratory and clinical performance of these tests by subsequently re-evaluating 201 urine samples that had been submitted for routine melanogen analysis. We used (a) Thormählen, (b) ferric chloride, (c) small-scale thin-layer chromatography, and (d) spectrophotometry. Nearly 30% of Thormählen test results were equivocal. The ferric chloride test was of no value in itself or in categorizing equivocal Thormählen results as positive or negative. The small-scale chromatography was irreproducible. Prompt scanning of the Thormählen reaction product was helpful in classifying equivocal results. History review of 121 histopathologically diagnosed melanoma patients indicated that these qualitative assays were of no clinical value in the diagnosis or monitoring of melanoma patients.
Heterogeneity of lipoprotein Lp(a) and apolipoprotein(a).
Abstract We have purified Lp(a) lipoproteins from sera of four subjects by ultracentrifugation, selective precipitation, and chromatofocusing. Each subject had two forms of serum Lp(a) that were separable by chromatofocusing. We purified apolipoprotein (a) [apo(a)] from the eight isolated Lp(a)s and obtained only one form of apo(a) from each subject. The four apo(a)s seen on sodium dodecyl sulfate-polyacrylamide gel electrophoresis had different apparent molecular masses, ranging from 275 to 440 kDa. Chemical deglycosylation of the smallest apo(a) yielded a 235 kDa protein, which may be a core protein structure common to all apo(a)s. We conclude that there are many forms of serum Lp(a) and apo(a). The heterogeneity of serum Lp(a) particles can be ascribed in part to differences in size of apo(a), but other factors must account for the existence within a single patient of different Lp(a)s that contain apparently identical apo(a). One must consider the heterogeneity of Lp(a) when designing assays for this lipoprotein.