[Clinical significance of serum ferritin H and L subunit determination in various diseases--evaluation by enzyme-linked immunosorbent assay].

Serum ferritin H and L subunit levels and H/L ratios were evaluated in normal subjects and patients with various diseases by means of enzyme-linked immunosorbent assay using monoclonal antibody against ferritin H or L subunits. In normal subjects, serum levels of H subunit were significantly lower than those of L subunit, as previously reported by Cazzola and coworkers. Although the serum levels of L subunit were elevated and the values of H/L ratios were decreased in inflammatory diseases, serum levels of H subunit were remarkably high in patients with infectious mononucleosis. In liver disease, elevation of mean values of L subunit was observed. However, in liver cirrhosis and severe acute hepatitis, the serum levels of H subunit were often elevated as well as those of L subunit, and so it was suggested that the elevation of H subunit was related to the degree of hepatocellular injury. In hepatocellular carcinoma and pancreatic cancer, since the levels of H/L ratio were higher than controls and no correlation was observed between H and L subunits, it was suggested that the production of H subunit was increased in these cancers. However, the result of H/L ratio determination in serum ferritin did not appear enough to be important for tumor marker, because of a few instances demonstrated over the cut off limit of H/L ratio in neoplastic diseases. The rate of the patients whose H or L subunit levels were over the cut off point was higher in leukemia than in solid cancer, and so it was likely that the measurement of H and L subunit at the same time was clinically useful in leukemic patients. In acute myeloblastic leukemia, relatively high levels of serum L subunits and low H/L ratio were shown. It was suggested that the measurement of H and L subunits in patients with neoplastic diseases would also be useful for monitoring the effect of the therapy.