Alpha 1-antitrypsin, transferrin, alkaline phosphatase, phosphohexoseisomerase and gamma-glutamyltransferase in breast cyst fluid.

The levels of alpha 1-antitrypsin, transferrin, alkaline phosphatase, phosphohexoseisomerase and gamma-glutamyltransferase were measured in 32 samples of breast cyst fluid, and a wide range of values was obtained. The levels observed in some samples for these parameters, being similar to those of normal serum, might suggest a mechanism of plasma exudation for the formation of breast cyst fluid. Nevertheless, a comparison with the maximum normal serum reference value revealed very high levels of gamma-glutamyltransferase in all of the samples; about 50% also exhibited high levels of phosphohexoseisomerase. These results indicate that the formation of breast cyst fluid takes place with a specific local production, in addition to the mechanism of selective plasma exudation. Moreover, elevated transferrin levels in some cyst fluids are probably the expression of a high biosynthetic activity and could be diagnostically useful in the course of breast gross cystic disease. The importance of these observations from the point of view of diagnostic and prognostic trends are discussed.