Transcobalamin II as an indicator of activity in metastatic renal adenocarcinoma

Transcobalamin (TC) II, the cellular membrane carrier of vitamin B 12 has recently attracted attention as an acute phase reactant in autoimmune disorders and reticuloendothelial malignancies. In a prospective clinical evaluation, 20 patients presenting with proven metastatic renal adenocarcinoma underwent nephrectomy and were followed till death, or at least 3 years. Two patients obtained a complete remission. TCII was significantly elevated (P less than 0.005) preoperatively and varied with activity of the carcinoma, supplementing the erythrocyte sedimentation rate and fibrinogen. The postoperative response and pattern of TCII activity correlated with disease progression. No relation was found to liver metastases. This study supports the recent findings of TCII as an indicator of activity in disorders affecting the immune mechanisms probably acting as an acute phase reactant, and is a useful supplement in renal adenocarcinoma.