Background: Gamma-glutamyltransferase is recognised as a biomarker to assess the harms associated with alcohol misuse. The objective ways to measure GGT in areas lacking central lab facilities are desirable. This stud...Background: Gamma-glutamyltransferase is recognised as a biomarker to assess the harms associated with alcohol misuse. The objective ways to measure GGT in areas lacking central lab facilities are desirable. This study aims to measure GGT from dried serum spots and its storage from dried serum spots. Method: The study was approved by the institutional ethical committee. One hundred and eighty (180) patients were included in the study. Their blood samples were collected. The serum samples were spotted onto filter paper (Whatman 903) dried and stored at 4°C. The GGT levels were measured on the day of collection and at various time periods to assess the effect of storage. All the analysis was performed on SPSS version 21. Result: The GGT levels measured from fresh serum GGT levels mean (SD) 286.5 (539.4) correlated well with their respective dried serum levels 287.18 (538.2) (P = 0.80). The mean recovery of GGT from dried serum was observed to be 103.3%. A sub-sample (n = 12) was stored at 4°C. The dried serum spots were found to be stable at the end of four weeks using repeated measure analysis of variance (ANOVA) (P = 0.39). Conclusion: This method has the potential to be used for epidemiological or field based studies to assess harms associated with alcohol use.展开更多
AIM: To determine the prognostic value of alkaline phosphatase(ALP) and γ-glutamyltransferase(GGT) for hepatocellular carcinoma(HCC).METHODS: We analyzed the outcome of 172 HCC patients who underwent liver resection....AIM: To determine the prognostic value of alkaline phosphatase(ALP) and γ-glutamyltransferase(GGT) for hepatocellular carcinoma(HCC).METHODS: We analyzed the outcome of 172 HCC patients who underwent liver resection. Receiver operating characteristic(ROC) curve analysis was performed to determine the cut-off value of ALP and GGT. Then, preoperative risk factors for survival were evaluated by multivariate analysis. Based on the significant factors, aprognostic score model was established.RESULTS: By ROC curve analysis, ALP > 120 U/L and GGT > 115 U/L were considered elevated. Overall survival(OS) and tumor-free survival(TFS) for patients with elevated ALP and GGT were significantly worse than for patients with ALP and GGT within the normal range. Multivariate analysis showed that the elevated levels of ALP, GGT and tumor size were independent prognostic factors. Giving each positive factor as a score of 1, we established a preoperative prognostic score model. The 5-year OS for patients with a score of 0, 1, 2 and 3 were 84.0%, 45.9%, 44.1% and 0%, respectively, while the TFS was 80.6%, 40.0%, 38.8% and 0%, respectively. When combining patients with scores of 1 and 2 into the middle risk group, and patients with scores of 0 and 3 into the low-risk and highrisk groups, respectively, different outcomes would be significantly distinguished by the risk groups.CONCLUSION: Elevated ALP and GGT levels were risk predictors in HCC patients. Our prognostic model might vary the outcomes of patients from different risk groups.展开更多
AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy bl...AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy blood donors. METHODS: This cross-sectional study was performed in 934 male blood donors, aged 18 to 68 years, who consecutively attended Tehran blood transfusion service in 2006. All participants were seronegative for HBV or HCV infections, non alcohol users, and all underwent a standard interview and anthropometric tests. Clinical and biochemical parameters including AST, ALT, and GGT activities were determined. Patients taking drugs known to cause hepatic fat deposition were excluded. For AST, ALT, and GGT variables, we used 33.33 and 66.66 percentiles, so that each of them was divided into three tertiles. RESULTS: Mean AST, ALT, and GGT activities were 25.26 ± 12.58 U/L (normal range 5-35 U/L), 33.13 ± 22.98 (normal range 5-35 U/L), and 25.11 ± 18.32 (normal range 6-37 U/L), respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body weight, body mass index, and waist and hip circumferences (P < 0.05). By multiple linear regression analyses, ALT was found to be positively correlated with dyslipidemia (B = 6.988, P = 0.038), whereas ALT and AST were negatively correlated with age. AST, ALT, and GGT levels had positive correlation with family history of liver disease (B = 15.763, P < 0.001), (B = 32.345, P < 0.001), (B =24.415, P < 0.001), respectively.CONCLUSION: Although we did not determine the cutoffs of the upper normal limits for AST, ALT, and GGT levels, we would suggest screening asymptomatic patients with dyslipidemia and also subjects with a family history of liver disease.展开更多
BACKGROUND Gamma-glutamyltransferase(GGT) is one of the most important laboratory tests for the evaluation of liver damage. Through a long-term clinical observation of patients with secondary asymptomatic choledocholi...BACKGROUND Gamma-glutamyltransferase(GGT) is one of the most important laboratory tests for the evaluation of liver damage. Through a long-term clinical observation of patients with secondary asymptomatic choledocholithiasis, we found that most patients had abnormal GGT serum levels.AIM To investigate the combination of serum GGT and alkaline phosphatase(ALP) in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis.METHODS In this retrospective cohort study, the clinical data of 829 patients with cholecystolithiasis admitted to the Third Affiliated Hospital of Zunyi Medical College from August 2014 to August 2017 were collected. Among these patients,151 patients had secondary asymptomatic choledocholithiasis and served as the observation group, and the remaining 678 cholecystolithiasis patients served as the control group. Serum liver function indexes were detected in both groups,and the receiver operating characteristic(commonly known as ROC) curves were constructed for markers showing statistical significances. The cutoff value,sensitivity, and specificity of each marker were calculated according to the ROC curves.RESULTS The overall incidence of asymptomatic choledocholithiasis secondary to cholecystolithiasis was 18.2%. The results of liver function indexes including serum aspartate aminotransferase, alanine aminotransferase, direct bilirubin and total bilirubin levels showed no significant differences between the two groups(P> 0.05). However, the serum GGT and ALP levels were significantly higher in the observation group than in the control group(P < 0.05). The ROC curve analysis showed that the area under the curve was 0.881(95%CI: 0.830-0.932), 0.647(95%CI: 0.583-0.711) and 0.923(0.892-0.953) for GGT, ALP, and GGT + ALP,respectively. The corresponding cut-off values of GGT and ALP were 95.5 U/L and 151.5 U/L, sensitivity were 90.8% and 65.1%, and specificity were 83.6% and59.8%, respectively. The sensitivity and specificity of GGT + ALP were 93.5% and85.1%, respectively.CONCLUSION An abnormally elevated serum GGT level has an important value in the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis.The combination of serum GGT and ALP has better diagnostic performance. As a convenient, rapid and inexpensive test, it should be applied in secondary asymptomatic choledocholithiasis routine screening.展开更多
BACKGROUND: Although the hepatoma-specific band of gamma-glutamyltransferase ( GGT ) is a highly sensitive marker in diagnosis of hepatocellular carcinoma, the kine- tic expression and the early alterations of GGT in ...BACKGROUND: Although the hepatoma-specific band of gamma-glutamyltransferase ( GGT ) is a highly sensitive marker in diagnosis of hepatocellular carcinoma, the kine- tic expression and the early alterations of GGT in the deve- lopment of hepatoma remain unclear. In this study, we in- vestigated the expression and the alterations of GGT multi- ple molecular forms in hepatotumorigenesis. METHODS: The expression of GGT in a chemically in- duced hepatocarcinogenesis model was examined by giving 0. 05% of 2-fluoenylacetamide in diet for 12 weeks. The ex- pression levels of total RNA and GGT, and the changes of liver pathology, GGT multiple molecular forms and sugar- chain heterogeneity were investigated at the different stages of rat hepatoma development. RESULTS: Pathological examination and biochemical ana- lysis found that liver GGT was over-expressed and secreted into blood during canceration. Serum total GGT and liver GGT specific activities (IU/g) including soluble and mem- brane-combined GGT were significantly higher (P <0.05) in experimental groups than those in control group, respec- tively. A highly positive correlation was found between to- tal GGT activities and total RNA levels (r =0.90, P <0.05) of the liver. Both were higher six weeks later than before. Con A-non-reactive-GGT was increased consistantly dur- ing the development of rat hepatoma. GGT multiple mo- lecular forms in the liver and sera of experimental rats showed that fetal liver-type GGT bands were associated with the development of hepatoma. CONCLUSIONS: Fetal liver-type GGT in sera and the liver of rats is closely related to hepatotumorigenesis. It can be used as a sensitive enzymatic marker for the early diagnosis of liver cancer.展开更多
BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma...BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.展开更多
AIM To assess how serum gamma-glutamyltransferase(GGT) fractions vary in patients with alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD). METHODS Serum samples were obtained from 14 patients wi...AIM To assess how serum gamma-glutamyltransferase(GGT) fractions vary in patients with alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD). METHODS Serum samples were obtained from 14 patients with biopsy-proven alcoholic liver diseases and 9 patients with biopsy proven non-alcoholic fatty liver disease. In addition to these biopsy-proven cases, 16 obese(body mass index > 25) patients without any history of alcohol consumption but with a fatty liver on ultrasound examination and with elevated GGT were included for an additional analysis. Serum GGT fractionation was conducted by high-performance gel filtration liquid chromatography and was separated into the four fractions, big-GGT, medium-GGT, small-GGT(s-GGT), and free-GGT(f-GGT).RESULTS The results were expressed as a ratio of each fraction including the total GGT(t-GGT). The s-GGT/t-GGT ratioswere lowest for the control group and highest for the ALD group. The differences between the control and NAFLD groups and also between the NAFLD and ALD groups were statistically significant. In contrast, the f-GGT/t-GGT ratios were highest in the control group and lowest in the ALD group, with the differences being statistically significant. As a result, the s-GGT/f-GGT ratios were markedly increased in the NAFLD group as compared with the control group. The increase of the s-GGT/t-GGT ratios, the decrease of the f-GGT/t-GGT ratios, and the increase of s-GGT/F-GGT ratios as compared with the control group subjects were also found in obese patients with clinically diagnosed fatty change of the liver.CONCLUSION Serum GGT fractionation by high-performance gel filtration liquid chromatography is potentially useful for the differential diagnosis of ALD and NAFLD.展开更多
Virulence of Helicobacter pylori,Helicobacter suis and other bacteria appears to be partly mediated through a release of gamma-glutamyltransferase(GGT),an enzyme activity capable of promoting biochemical reactions ult...Virulence of Helicobacter pylori,Helicobacter suis and other bacteria appears to be partly mediated through a release of gamma-glutamyltransferase(GGT),an enzyme activity capable of promoting biochemical reactions ultimately resulting in damage to gastric epithelium and suppression of immune response.Recently published studies show that secretion of bacterial GGT occurs in the form of exosome-like vesicles.Very similar GGT-rich exosomes have been described to originate from human cancer cells,and the hypothesis is thus forwarded that in the resistant and invasive phenotype of malignant cells such vesicular/exosomal GGT may play roles akin to those described for Helicobacter infection,thus providing a significant contribution to the establishment of cancer metastases.展开更多
目的探讨γ-谷氨酰转移酶(γ-glutamyltransferase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)和外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)联合检测在肝癌诊断中的应用价值。方法回顾性选取2012年1月至202...目的探讨γ-谷氨酰转移酶(γ-glutamyltransferase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)和外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)联合检测在肝癌诊断中的应用价值。方法回顾性选取2012年1月至2020年12月广西医科大学附属武鸣医院收治的100例肝癌患者纳入肝癌组,100例肝硬化患者纳入肝硬化组,100例肝炎患者纳入肝炎组,另选取本院同期健康体检者100人纳入健康体检组。比较四组受试者的GGT、ALP、NLR水平,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评价各指标对肝癌的诊断效能。结果肝癌组患者的NLR、GGT和ALP水平均显著高于肝硬化组、肝炎组和健康体检组(P<0.05);肝硬化组患者的NLR显著高于健康体检组和肝炎组(P<0.05);肝硬化组和肝炎组患者的GGT和ALP均显著高于健康体检组(P<0.05)。Spearman相关分析结果显示,NLR与GGT、ALP均呈正相关,GGT与ALP呈正相关(P<0.05)。NLR、GGT和ALP单独检测诊断肝癌时,NLR的曲线下面积(area under the curve,AUC)最大,为0.943(95%CI:0.901~0.971,P<0.001),ALP的AUC最小。三者联合检测的AUC为0.987(95%CI:0.959~0.998),敏感度为99.0%。结论NLR、GGT、ALP联合检测可显著提高肝癌的检出率,联合检测有更好的应用价值。展开更多
文摘Background: Gamma-glutamyltransferase is recognised as a biomarker to assess the harms associated with alcohol misuse. The objective ways to measure GGT in areas lacking central lab facilities are desirable. This study aims to measure GGT from dried serum spots and its storage from dried serum spots. Method: The study was approved by the institutional ethical committee. One hundred and eighty (180) patients were included in the study. Their blood samples were collected. The serum samples were spotted onto filter paper (Whatman 903) dried and stored at 4°C. The GGT levels were measured on the day of collection and at various time periods to assess the effect of storage. All the analysis was performed on SPSS version 21. Result: The GGT levels measured from fresh serum GGT levels mean (SD) 286.5 (539.4) correlated well with their respective dried serum levels 287.18 (538.2) (P = 0.80). The mean recovery of GGT from dried serum was observed to be 103.3%. A sub-sample (n = 12) was stored at 4°C. The dried serum spots were found to be stable at the end of four weeks using repeated measure analysis of variance (ANOVA) (P = 0.39). Conclusion: This method has the potential to be used for epidemiological or field based studies to assess harms associated with alcohol use.
基金Supported by National natural science foundation of China,No.81272644 and No.81201549
文摘AIM: To determine the prognostic value of alkaline phosphatase(ALP) and γ-glutamyltransferase(GGT) for hepatocellular carcinoma(HCC).METHODS: We analyzed the outcome of 172 HCC patients who underwent liver resection. Receiver operating characteristic(ROC) curve analysis was performed to determine the cut-off value of ALP and GGT. Then, preoperative risk factors for survival were evaluated by multivariate analysis. Based on the significant factors, aprognostic score model was established.RESULTS: By ROC curve analysis, ALP > 120 U/L and GGT > 115 U/L were considered elevated. Overall survival(OS) and tumor-free survival(TFS) for patients with elevated ALP and GGT were significantly worse than for patients with ALP and GGT within the normal range. Multivariate analysis showed that the elevated levels of ALP, GGT and tumor size were independent prognostic factors. Giving each positive factor as a score of 1, we established a preoperative prognostic score model. The 5-year OS for patients with a score of 0, 1, 2 and 3 were 84.0%, 45.9%, 44.1% and 0%, respectively, while the TFS was 80.6%, 40.0%, 38.8% and 0%, respectively. When combining patients with scores of 1 and 2 into the middle risk group, and patients with scores of 0 and 3 into the low-risk and highrisk groups, respectively, different outcomes would be significantly distinguished by the risk groups.CONCLUSION: Elevated ALP and GGT levels were risk predictors in HCC patients. Our prognostic model might vary the outcomes of patients from different risk groups.
文摘AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy blood donors. METHODS: This cross-sectional study was performed in 934 male blood donors, aged 18 to 68 years, who consecutively attended Tehran blood transfusion service in 2006. All participants were seronegative for HBV or HCV infections, non alcohol users, and all underwent a standard interview and anthropometric tests. Clinical and biochemical parameters including AST, ALT, and GGT activities were determined. Patients taking drugs known to cause hepatic fat deposition were excluded. For AST, ALT, and GGT variables, we used 33.33 and 66.66 percentiles, so that each of them was divided into three tertiles. RESULTS: Mean AST, ALT, and GGT activities were 25.26 ± 12.58 U/L (normal range 5-35 U/L), 33.13 ± 22.98 (normal range 5-35 U/L), and 25.11 ± 18.32 (normal range 6-37 U/L), respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body weight, body mass index, and waist and hip circumferences (P < 0.05). By multiple linear regression analyses, ALT was found to be positively correlated with dyslipidemia (B = 6.988, P = 0.038), whereas ALT and AST were negatively correlated with age. AST, ALT, and GGT levels had positive correlation with family history of liver disease (B = 15.763, P < 0.001), (B = 32.345, P < 0.001), (B =24.415, P < 0.001), respectively.CONCLUSION: Although we did not determine the cutoffs of the upper normal limits for AST, ALT, and GGT levels, we would suggest screening asymptomatic patients with dyslipidemia and also subjects with a family history of liver disease.
基金Supported by the Guizhou Provincial Department of Health Science and Technology Fund,No.GZWJKJ2014-2-151the Science and Technology Fund of Guizhou Province,No.QKH LH [2016]7421the Zunyi Science and Technology Research and Development Fund,No.ZSKHS[2016] 06
文摘BACKGROUND Gamma-glutamyltransferase(GGT) is one of the most important laboratory tests for the evaluation of liver damage. Through a long-term clinical observation of patients with secondary asymptomatic choledocholithiasis, we found that most patients had abnormal GGT serum levels.AIM To investigate the combination of serum GGT and alkaline phosphatase(ALP) in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis.METHODS In this retrospective cohort study, the clinical data of 829 patients with cholecystolithiasis admitted to the Third Affiliated Hospital of Zunyi Medical College from August 2014 to August 2017 were collected. Among these patients,151 patients had secondary asymptomatic choledocholithiasis and served as the observation group, and the remaining 678 cholecystolithiasis patients served as the control group. Serum liver function indexes were detected in both groups,and the receiver operating characteristic(commonly known as ROC) curves were constructed for markers showing statistical significances. The cutoff value,sensitivity, and specificity of each marker were calculated according to the ROC curves.RESULTS The overall incidence of asymptomatic choledocholithiasis secondary to cholecystolithiasis was 18.2%. The results of liver function indexes including serum aspartate aminotransferase, alanine aminotransferase, direct bilirubin and total bilirubin levels showed no significant differences between the two groups(P> 0.05). However, the serum GGT and ALP levels were significantly higher in the observation group than in the control group(P < 0.05). The ROC curve analysis showed that the area under the curve was 0.881(95%CI: 0.830-0.932), 0.647(95%CI: 0.583-0.711) and 0.923(0.892-0.953) for GGT, ALP, and GGT + ALP,respectively. The corresponding cut-off values of GGT and ALP were 95.5 U/L and 151.5 U/L, sensitivity were 90.8% and 65.1%, and specificity were 83.6% and59.8%, respectively. The sensitivity and specificity of GGT + ALP were 93.5% and85.1%, respectively.CONCLUSION An abnormally elevated serum GGT level has an important value in the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis.The combination of serum GGT and ALP has better diagnostic performance. As a convenient, rapid and inexpensive test, it should be applied in secondary asymptomatic choledocholithiasis routine screening.
基金This study was supported by a grant from Key Projects of Medical Sciences Department of Health , Jiangsu Province, China ( RC2003100 ).
文摘BACKGROUND: Although the hepatoma-specific band of gamma-glutamyltransferase ( GGT ) is a highly sensitive marker in diagnosis of hepatocellular carcinoma, the kine- tic expression and the early alterations of GGT in the deve- lopment of hepatoma remain unclear. In this study, we in- vestigated the expression and the alterations of GGT multi- ple molecular forms in hepatotumorigenesis. METHODS: The expression of GGT in a chemically in- duced hepatocarcinogenesis model was examined by giving 0. 05% of 2-fluoenylacetamide in diet for 12 weeks. The ex- pression levels of total RNA and GGT, and the changes of liver pathology, GGT multiple molecular forms and sugar- chain heterogeneity were investigated at the different stages of rat hepatoma development. RESULTS: Pathological examination and biochemical ana- lysis found that liver GGT was over-expressed and secreted into blood during canceration. Serum total GGT and liver GGT specific activities (IU/g) including soluble and mem- brane-combined GGT were significantly higher (P <0.05) in experimental groups than those in control group, respec- tively. A highly positive correlation was found between to- tal GGT activities and total RNA levels (r =0.90, P <0.05) of the liver. Both were higher six weeks later than before. Con A-non-reactive-GGT was increased consistantly dur- ing the development of rat hepatoma. GGT multiple mo- lecular forms in the liver and sera of experimental rats showed that fetal liver-type GGT bands were associated with the development of hepatoma. CONCLUSIONS: Fetal liver-type GGT in sera and the liver of rats is closely related to hepatotumorigenesis. It can be used as a sensitive enzymatic marker for the early diagnosis of liver cancer.
文摘BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.
文摘AIM To assess how serum gamma-glutamyltransferase(GGT) fractions vary in patients with alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD). METHODS Serum samples were obtained from 14 patients with biopsy-proven alcoholic liver diseases and 9 patients with biopsy proven non-alcoholic fatty liver disease. In addition to these biopsy-proven cases, 16 obese(body mass index > 25) patients without any history of alcohol consumption but with a fatty liver on ultrasound examination and with elevated GGT were included for an additional analysis. Serum GGT fractionation was conducted by high-performance gel filtration liquid chromatography and was separated into the four fractions, big-GGT, medium-GGT, small-GGT(s-GGT), and free-GGT(f-GGT).RESULTS The results were expressed as a ratio of each fraction including the total GGT(t-GGT). The s-GGT/t-GGT ratioswere lowest for the control group and highest for the ALD group. The differences between the control and NAFLD groups and also between the NAFLD and ALD groups were statistically significant. In contrast, the f-GGT/t-GGT ratios were highest in the control group and lowest in the ALD group, with the differences being statistically significant. As a result, the s-GGT/f-GGT ratios were markedly increased in the NAFLD group as compared with the control group. The increase of the s-GGT/t-GGT ratios, the decrease of the f-GGT/t-GGT ratios, and the increase of s-GGT/F-GGT ratios as compared with the control group subjects were also found in obese patients with clinically diagnosed fatty change of the liver.CONCLUSION Serum GGT fractionation by high-performance gel filtration liquid chromatography is potentially useful for the differential diagnosis of ALD and NAFLD.
基金Supported by University of Pisa School of Medicine research funds(2013)
文摘Virulence of Helicobacter pylori,Helicobacter suis and other bacteria appears to be partly mediated through a release of gamma-glutamyltransferase(GGT),an enzyme activity capable of promoting biochemical reactions ultimately resulting in damage to gastric epithelium and suppression of immune response.Recently published studies show that secretion of bacterial GGT occurs in the form of exosome-like vesicles.Very similar GGT-rich exosomes have been described to originate from human cancer cells,and the hypothesis is thus forwarded that in the resistant and invasive phenotype of malignant cells such vesicular/exosomal GGT may play roles akin to those described for Helicobacter infection,thus providing a significant contribution to the establishment of cancer metastases.
文摘目的探讨γ-谷氨酰转移酶(γ-glutamyltransferase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)和外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)联合检测在肝癌诊断中的应用价值。方法回顾性选取2012年1月至2020年12月广西医科大学附属武鸣医院收治的100例肝癌患者纳入肝癌组,100例肝硬化患者纳入肝硬化组,100例肝炎患者纳入肝炎组,另选取本院同期健康体检者100人纳入健康体检组。比较四组受试者的GGT、ALP、NLR水平,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评价各指标对肝癌的诊断效能。结果肝癌组患者的NLR、GGT和ALP水平均显著高于肝硬化组、肝炎组和健康体检组(P<0.05);肝硬化组患者的NLR显著高于健康体检组和肝炎组(P<0.05);肝硬化组和肝炎组患者的GGT和ALP均显著高于健康体检组(P<0.05)。Spearman相关分析结果显示,NLR与GGT、ALP均呈正相关,GGT与ALP呈正相关(P<0.05)。NLR、GGT和ALP单独检测诊断肝癌时,NLR的曲线下面积(area under the curve,AUC)最大,为0.943(95%CI:0.901~0.971,P<0.001),ALP的AUC最小。三者联合检测的AUC为0.987(95%CI:0.959~0.998),敏感度为99.0%。结论NLR、GGT、ALP联合检测可显著提高肝癌的检出率,联合检测有更好的应用价值。