title: Evaluation of the albumin-gamma-glutamyltransferase isoenzyme as a diagnostic marker of hepatocellular carcinoma-complicating liver cirrhosis.
abstract: 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.
authors.affiliation: Department of Internal Medicine and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Giovanni
authors.initials: G
authors.lastname: Addolorato
authors.forename: Giulia
authors.initials: G
authors.lastname: Pignataro
authors.forename: Cristina
authors.initials: C
authors.lastname: Rossi
authors.forename: Cecilia
authors.initials: C
authors.lastname: Zuppi
authors.forename: Marcello
authors.initials: M
authors.lastname: Covino
authors.forename: Antonio
authors.initials: A
authors.lastname: Grieco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Gian Ludovico
authors.initials: GL
authors.lastname: Rapaccini
mesh_terms: 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
chemical_list: D000418:Albumins; D014408:Biomarkers, Tumor; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D005723:gamma-Glutamyltransferase