Serum levels of cytokeratin-18 (tissue polypeptide-specific antigen) in liver diseases.
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.
Gonzalez-Quintela
Arturo
A
Department of Internal Medicine, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. mearturo@usc.es
Mallo
Nieves
N
Mella
Carmen
C
Campos
Joaquín
J
Perez
Luis-Fernando
LF
Lopez-Rodriguez
Raimundo
R
Tome
Santiago
S
Otero
Esteban
E
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*
D010455:Peptides; C089984:tissue polypeptide specific antigen; D000410:Alanine Transaminase