Evaluation of the albumin-gamma-glutamyltransferase isoenzyme as a diagnostic marker of hepatocellular carcinoma-complicating liver cirrhosis.
OBJECTIVE
The present study aimed to evaluate the usefulness of albumin-gamma-glutamyltransferase isoenzyme in the diagnosis of hepatocellular carcinoma.


METHODS
Electrophoretic assays of gamma-glutamyltransferase isoenzymes were performed on sera from 190 cirrhotics with (n = 131) or without (n = 59) hepatocellular carcinoma, 36 patients with chronic active hepatitis, 17 patients with liver metastases, and 16 control subjects. In the group of cirrhotic patients, the serum level of alpha-fetoprotein was also assessed.


RESULTS
Albumin-gamma-glutamyltransferase was found in 88 of 131 cirrhotics with hepatocellular carcinoma, 14 of 59 cirrhotics without hepatocellular carcinoma, nine of 17 patients with liver metastases, and in none of the chronic active hepatitis or control patients. Within the cirrhotic subgroup, albumin-gamma-glutamyltransferase was effective in detecting hepatocellular carcinoma in general (sensitivity: 67%; specificity: 76%; diagnostic accuracy: 70%), and small hepatocellular carcinoma (< 3 cm; corresponding figures: 58, 76, and 69%). The best alpha-fetoprotein value discriminating between hepatocellular carcinoma and non-hepatocellular carcinoma cirrhotics was 20 ng/mL (sensitivity: 54%; specificity 85%; accuracy: 64%). The combined use of albumin-gamma-glutamyltransferase and alpha-fetoprotein, > 20 ng/mL, was associated with greater sensitivity and accuracy (84 and 74%, respectively) than those observed with either of the two markers considered alone.


CONCLUSIONS
Albumin-gamma-glutamyltransferase appears to be a sensitive diagnostic marker of both advanced and small hepatocellular carcinoma-complicating liver cirrhosis.
Pompili
Maurizio
M
Department of Internal Medicine and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
Addolorato
Giovanni
G
Pignataro
Giulia
G
Rossi
Cristina
C
Zuppi
Cecilia
C
Covino
Marcello
M
Grieco
Antonio
A
Gasbarrini
Giovanni
G
Rapaccini
Gian Ludovico
GL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006521:Hepatitis, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood
D000418:Albumins; D014408:Biomarkers, Tumor; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase