title: Serum levels of cytokeratin-18 (tissue polypeptide-specific antigen) in liver diseases.
abstract: OBJECTIVE
  The tissue polypeptide-specific antigen (TPS, cytokeratin-18, a normal constituent of the hepatocyte cytoskeleton) is a standard tumour marker. This study aimed to evaluate serum TPS levels in patients with liver disease.
  
  
  METHODS
  Serum TPS was measured with a commercial immunoassay in 884 individuals (753 outpatients from a liver disease clinic, 131 patients admitted to the hospital with acute liver disease).
  
  
  RESULTS
  Abnormally high (> 80 U/l) TPS levels were found in 57.7% (95% CI 54.0-61.3%) of outpatients with liver disease. Elevated TPS levels were observed for all liver diseases, including fatty liver, alcoholic disease, chronic viral hepatitis, autoimmune hepatitis, cholestasis, transplantation, and hepatocarcinoma. TPS levels correlated with liver markers, particularly serum AST. In addition, TPS levels correlated with Knodell's score in patients with chronic hepatitis. TPS was increased in one-third of patients with normal liver enzyme values. Serum TPS levels decreased after specific therapy in patients with hepatitis C and autoimmune hepatitis. Abnormally high TPS levels were found in the vast majority of patients admitted to the hospital, with markedly high (> 800 U/l) values being observed in 47.5% (95% CI 36.1-55.7%) of patients with alcoholic liver disease and in 80.8% (95% CI 60.0-92.7%) of patients with acute hepatitis.
  
  
  CONCLUSIONS
  Serum TPS (cytokeratin-18) is elevated in patients with non-malignant liver diseases, particularly in those with prominent cytolysis. Further studies are needed to evaluate the use of TPS as a marker of liver disease.
authors.affiliation: Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. mearturo@usc.es
authors.forename: Arturo
authors.initials: A
authors.lastname: Gonzalez-Quintela
authors.forename: Nieves
authors.initials: N
authors.lastname: Mallo
authors.forename: Carmen
authors.initials: C
authors.lastname: Mella
authors.forename: Joaquín
authors.initials: J
authors.lastname: Campos
authors.forename: Luis-Fernando
authors.initials: LF
authors.lastname: Perez
authors.forename: Raimundo
authors.initials: R
authors.lastname: Lopez-Rodriguez
authors.forename: Santiago
authors.initials: S
authors.lastname: Tome
authors.forename: Esteban
authors.initials: E
authors.lastname: Otero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*
chemical_list: D010455:Peptides; C089984:tissue polypeptide specific antigen; D000410:Alanine Transaminase