五项肝酶学指标在肝癌诊断上的意义

目的:了解а-岩藻糖苷酶(AFU)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)五项肝酶学指标在肝癌诊断中的意义。方法:使用全自动生化分析仪对156例肝病患者和30例正常人血清中五项肝酶学指标进行检测,对检测结果进行统计学分析。结果:原发性肝癌组AFU、ALT、AST、ALP、GGT五项指标均明显增高,其中AFU的血清含量为(39.5±1.76),与转移性肝癌组有差异,与良性肝占位性病变(肝血管瘤、肝囊肿等)有明显的差异P<0.05;原发性肝癌组和转移性肝癌组ALP、GGT均显著增高,与良性肝占位性病变有明显的差异P<0.05;转移性肝癌组血清ALT活性为(132.0±190.7),与原发性肝癌组血清ALT活性(64.0±25.4)相比,明显的增高P<0.05。结论:AFU、ALP、GGT在肝癌的诊断中有较好的应用价值;AFU、ALT在原发性肝癌与转移性肝癌以及良性肝占位性病变的鉴别诊断中有较好的应用价值。

心源性黄疸的临床鉴别

[目的]阐明严重心脏病引起不同类别肝损伤的差异和测定方法,以利于对缺血性肝病的早期诊治。[方法]选择20例心力衰竭致肝淤血性损伤和4例缺血肝病例进行临床和实验室观测与对比研究。[结果]淤血肝损伤多较轻,随心衰控制而好转;而缺血性肝病可致严重肝损伤,“三项酶”包括血谷丙转氨酶、乳酸脱氢酶、谷氨酸脱氢酶,Ⅱ组的检测结果均明显高于Ⅰ组(P<0.05),尤为谷氨酸脱氢酶的检测具有更重要的鉴别意义。[结论]心源性黄疸的鉴别中,除临床表现二者不同特点外,“三项酶”的同时监测,可助缺血肝的早期诊断和有效治疗。

Detection of Syndecan-1 and Heparanase-1 Genes in Esophageal Carcinoma by Quantitative RT-PCR

OBJECTIVE To quantitatively explore the expression of Syndecan-1 and heparanase-1 in esophageal cancer tissue as well as their relationship with the clinicopathological factors, in order to evaluate their roles in tumor invasion and metastasis.METHODS Real-time fluorescence quantitative PCR （Q-PCR） was used to analyze the expression levels of Syndecan-1 and heparanase-1 genes￡？participants included 67 cases with esophageal cancers and 32 healthy volunteers.RESULTS The expression of Heparanase-1 gene in esophageal cancers was higher than that in normal esophageal tissue （P 〈 0.001）, and the expression of Syndecan-1 gene in the normal esophageal tissue was higher compared with esophageal cancers （P 〈 0.001）. The positive rates of Syndecan-1 and Heparanase-1 gene in esophageal cancer were 13.4% （9/67） and 85.1% （57/67）.The expression of Syndecan-1 and Heparanase-1 genes was signifi cantly related to di. erentiation, depth of infi ltration, lymph node metastasis, vessel metastasis, and TNM stages of disease （P 〈 0.05）. In an attempt to measure the association between the 2 agents, this study found that the expression of Syndecan-1 mRNA had a significantly negative correlation with the expression of Heparanase-1 mRNA by using Spearman rank correlation test （OR = -0.572, P 〈 0.001）.CONCLUSION Syndecan-1 and Heparanase-1 play important roles in the invasion and metastasis of esophageal cancer. The reduction of Syndecan-1 and/or the increase of Heparanase-1 may influence the invasion and metastasis of malignant tumors.Thus the combination assay of Syndecan-1 and Heparanase-1 may contribute to the diagnosis and treatment of malignant tumors.

Using a non-radioisotopic, quantitative TRAP-based method detecting telomerase activities in human hepatoma cells

A non-radioisotopic, quantitative TRAP-based telomerase activity assay was established mainly by using SYBR Green-I staining instead of radioisotope. Comparing with conventional radioisotope based method, it was better in reproducibility and accuracy. Using this method, we found telomerase activities were absent in normal human liver cells, while detected in ail of four human hepatoma cell lines (BEL-7404, SMMC-7721, QGY-7903 and HCCM) without significant differences.

Comparison of ligase detection reaction and real-time PCR for detection of low abundant YMDD mutants in patients with chronic hepatitis B

AIM: To compare the ligase detection reaction (LDR) and real-time PCR for detection of low abundant YMDD mutants in patients with chronic hepatitis B infection.METHODS: Mixtures of plasmids and serum samples from 52 chronic hepatitis B patients with low abundant lamivudine-resistant mutations were tested with LDR and real-time PCR. Time required and reagent cost for both assays were evaluated.RESULTS: Real-time PCR detected 100, 50, 10, 1 and 0.1% of YIDD plasmid, whereas LDR detected 100, 50, 10, 1, 0.1, and 0.01% of YIDD plasmid, in mixtures with YMDD plasmid of 106 copies/mL. Among the 52 clinical serum samples, completely concordant results were obtained for all samples by both assays, and 39 YIDD, 9 YVDD, and 4 YIDD/YVDD were detected. Cost and time required for LDR and real-time PCR are 60/80 CNY (8/10.7 US dollars) and 4.5/2.5 h, respectively.CONCLUSION: LDR and real-time PCR are both sensitive and inexpensive methods for monitoring low abundant YMDD mutants during lamivudine therapy in patients with chronic hepatitis B. LDR is more sensitive and less expensive, while real-time PCR is more rapid.

Microproteinuria for detecting calcineurin inhibitor-related nephrotoxicity after liver transplantation

AIM： To investigate whether microproteinuria could be used as an early and sensitive indicator to detect calcineurin inhibitor （CNI）-related nephrotoxicity after liver transplantation.METHODS： All liver transplant recipients with normal serum creatinine （SCr） and detectable microproteinuria at baseline were included in this study. The renal function was monitored by the blood clearance of 99mTc-diethylenetriaminepentaacetic acid every 6 mo. Microproteinuria, SCr and blood urea nitrogen （BUN） were measured at entry and at subsequent follow-up visits. The patients were divided into different groups according to the mean values of glomerular filtration rate （GFR） at the follow-up time points： Group 1, GFR decreased from baseline by 0%-10%; Group 2, GFR decreased from baseline by 11%-20%; Group 3, GFR decreased from baseline by 21%-40%; Group 4, GFR decreased from baseline by 〉 40% and/or SCr was increasing.RESULTS： A total of 143 patients were enrolled into this study （23 females and 120 males）. The mean follow-up was 32 mo （range 16-36 mo）. Downward trends in renal function over time were observed in the study groups. SCr and BUN increased significantly only in Group 4 patients （P 〈 0.001）. β2-microglobulin （β2m） and al-microglobulin （αlm） significantly increased with the subtle change of renal function in recipients who were exposed to CNI-based immunosuppression regimens. The reductions in GFR were closely correlated with elevated cclm （P = -0.728, P 〈 0.001） and β2m （r2 = -0.787, P 〈 0.001）.CONCLUSION： β2m and α1m could be useful as early and sensitive indicators of CNI-induced nephrotoxicity.

Measurement of serum paraoxonase-1 activity in the evaluation of liver function

Paraoxonase-1 (PON1) is an esterase and lactonase synthesized by the liver and found in the circulation associated with high-density lipoproteins. The physiological function of PON1 seems to be to degrade specific oxidized cholesteryl esters and oxidized phospholipids in lipoproteins and cell membranes. PON1 is, therefore, an antioxidant enzyme. Alterations in circulating PON1 levels have been reported in a variety of diseases involving oxidative stress including chronic liver diseases. Measurement of serum PON1 activity has been proposed as a potential test for the evaluation of liver function. However, this measurement is still restricted to research and has not been extensively applied in routine clinical chemistry laboratories. The reason for this restriction is due to the problem that the substrate commonly used for PON1 measurement, paraoxon, is toxic and unstable. The recent development of new assays with non-toxic substrates makes this proposal closer to a practical development. The present editorial summarizes PON1 biochemistry and function, its involvement with chronic liver impairment, and some aspects related to the measurement of PON1 activity in circulation.

Circulating adiponectin: a potential prognostic marker for hepatocellular carcinoma

Objective: We planned this study to investigate the relation between serum adiponectin level and hepatocellular carcinoma (HCC): risk, features and prognosis. Methods: The study included 100 patients with HCC and 40 healthy control subjects. Adiponectin levels were determined by an enzyme-linked immunosorbent assay kit. Results: In the subset of patients with compensated cirrhosis, the mean serum adiponectin level was significantly lower in HCC cases compared to healthy controls (88.6 versus 115 ng/mL; P = 0.012). In addition, serum adiponectin levels correlated negatively with tumor size (P = 0.004) and were significantly lower in patients with vascular invasion and distant metastases (P = 0.03 and P = 0.02 respectively). Furthermore, the median overall survival was significantly higher in the high adiponectin group than the low adiponectin group (median 12.5 versus 9.5 months; log rank = 4.6, P = 0.03). Conclusion: Decreased circulating adiponectin level may play a role in the development of HCC and is a potential poor prognostic marker. These data should be validated in further prospective studies. Also the mechanisms by which adiponectin affect the course of HCC need to be clarified.

A new polymorphism in the GRP78 is not associated with HBV invasion

AIM:To examine the association between -86 bp(T>A) in the glucose-regulated protein 78 gene(GRP78) and hepatitis B virus(HBV) invasion.METHODS:DNA was genotyped for the single-nucleotide polymorphism by polymerase chain reaction followed by sequencing in a sample of 382 unrelated HBV carriers and a total of 350 sex-and age-matched healthy controls.Serological markers for HBV infection were determined by enzyme-linked immunosorbent as-say kits or clinical chemistry testing.RESULTS:The distributions of allelotype and genotype in cases were not significantly different from those in controls.In addition,our fi ndings suggested that neither alanine aminotransferase/hepatitis B e antigen nor HBV-DNA were associated with the allele/genotype variation in HBV infected individuals.CONCLUSION:-86 bp T>A polymorphism in GRP78 gene is not related to the clinical risk and acute exacerbation of HBV invasion.