Helicobacter pylori gamma-glutamyl transpeptidase and its pathogenic role

Helicobacter pylori(H.pylori)gamma-glutamyl transpeptidase(GGT)is a bacterial virulence factor that converts glutamine into glutamate and ammonia,and converts glutathione into glutamate and cysteinylglycine.H.pylori GGT causes glutamine and glutathione consumption in the host cells,ammonia production and reactive oxygen species generation.These products induce cell-cycle arrest,apoptosis,and necrosis in gastric epithelial cells.H.pylori GGT may also inhibit apoptosis and induce gastric epithelial cell proliferation through the induction of cyclooxygenase-2,epidermal growth factor-related peptides,inducible nitric oxide synthase and interleukin-8.H.pylori GGT induces immune tolerance through the inhibition of T cell-mediated immunity and dendritic cell differentiation.The effect of GGT on H.pylori colonization and gastric persistence are also discussed.

Helicobacter pylori γ-glutamyl transpeptidase:A formidable virulence factor

Helicobacter pylori(H.pylori)produce an enzyme known asγ-glutamyl transpeptidase(HpGGT)that is highly conserved and common to all strains.HpGGT has been gaining increasing attention as an important virulence factor of the bacterium,having been demonstrated to be an important colonization factor in several animal models and has also recently been strongly associated with the development of peptic ulcer disease.From the results of various independent researcher groups,it is clear that HpGGT acts through several pathways to damage gastric epithelial cells including the induction of apoptosis and cell cycle arrest,production of reactive oxygen species leading to DNA damage,promotion of inflammation by increasing cyclooxygenase-2 and interleukin-8 expression,and upregulation of heparin-binding epidermal growth factor-like growth factor resulting in cell survival and proliferation.In addition,the potential role of HpGGT in promoting gastric carcinogenesis will also be discussed in this review.Apart from affecting the gastric epithelium,HpGGT also has immunomodulatory actions on host immune cells where it displays an antiproliferative effect on T cells by inducing cell cycle arrest and also works with other H.pylori virulence factors to skew dendritic cells towards a tolerogenic phenotype,possibly contributing to the persistence of the pathogen in the gastric mucosa.

Prognostic role of plasma levels ofγ-glutamyl transpeptidase in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy

Objective Antibodies targeting programmed cell death protein 1(PD-1)have become the mainstay of treatment for chemotherapy-refractory gastric cancer,characterized by high levels of programmed cell death ligand-1(PDL-1)expression.However,the routine clinical implementation of PDL-1 testing is currently limited by the lack of robust detection methods.In this regard,the role of plasmaγ-glutamyl transpeptidase(GGT),an N-terminal nucleophilic hydrolase,as an independent predictor of the efficacy of anti-PD-1 therapy remains unknown.In this study,we aimed to assessed the prognostic role of changes in plasma GGT levels(6 weeks vs.baseline)in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy.Methods We retrospectively analyzed data from 57 patients with gastric cancer treated with anti-PD-1 antibodies(camrelizumab,sintilimab,nivolumab,tislelizumab,and toripalimab)at the Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China,from July 2018 to February 2021.Results We found that after 6 weeks of treatment,there were significant differences between responders and non-responders with respect to plasma GGT levels(P<0.001).Multivariate logistic regression analysis revealed that the continuous value of the 6-week difference in GGT levels(OR=1.437,95%CI=1.116-1.849,P=0.005)and 6-week difference in GGT≥0 or<0(OR=53.675,95%CI=6.379-451.669,P<0.001)were independent predictors of disease control.Survival analysis indicated that a reduction in plasma GGT6 levels during treatment was significantly associated with a favorable progression-free survival(PFS)and overall survival(P<0.001).Consistently,univariate and multivariate Cox regression analyses revealed that a reduction in plasma GGT6 levels during treatment was an independent predictor of PFS(HR=1.033,95%CI=1.013-1.053,P=0.001).Conclusion Alterations in plasma GGT levels during treatment can be used as a predictor of disease progression and survival in patients with advanced gastric cancer undergoing treatment with anti-PD-1 antibodies.

窒息新生儿NAG及GGT的改变及临床意义

目的 :比较尿中N -乙酰 - β氨基酸葡萄糖苷酶 (NAG)、γ -氨酰转移酶 (GGT)及血清尿素氮 (BUN)、肌苷 (Cr)等指标在窒息新生儿肾功能损伤的早期诊断中的作用。方法 :测定对照组、轻度窒息组和重度窒息组新生儿的血清中BUN、Cr、尿中NAG和GGT。结果 :发现血清BUN、Cr各组间比较差异无显著性 (P >0 .0 5 ) ;尿中NAG及GGT轻度窒息组高于对照组 ,差异具显著性 (P <0 .0 5 ) ;重度窒息组较轻度窒息组和对照组明显升高 ,差异具显著性 (P <0 .0 5 )。结论 :提示尿中NAG、GGT活性是对窒息新生儿肾损伤的早期诊断及损伤程度的判定的一个灵敏指标。

血清标志物AFP、CEA、GGT的联合检测在原发性肝癌诊断中的临床价值

目的探讨血清标志物甲胎蛋白(AFP)、癌胚抗原(CEA)及谷氨酸氨基转肽酶(GGT)联合检测对原发性肝癌诊断的临床意义。方法随机选取检测者200例作为研究对象,分为原发性肝癌组、乙型肝炎肝硬化组、慢性乙型肝炎组、健康体检组,各50例,用电化学发光免疫分析检测AFP、CEA,用速率法检测GGT血清水平并计算阳性率、灵敏度、特异度。结果乙型肝炎肝硬化组、慢性乙型肝炎组AFP、CEA、GGT多呈低浓度阳性,分别不超过200 ng/m L、10 ng/m L、100 U/L,乙型肝炎肝硬化组AFP、CEA、GGT分别为(4.440±2.850)ng/m L、(3.761 60±2.142 95)ng/m L、(33.420±36.169)U/L,慢性乙型肝炎组AFP、CEA、GGT分别为(15.010±30.346)ng/m L、(2.222 60±1.439 15)ng/m L、(55.880±37.365)U/L,健康体检组多正常,原发性肝癌组多异常升高,显著高于其它3组,差异具有统计学意义(P<0.05),三项联合检测阳性率高于单项检测阳性率及任意两项联合检测阳性率,差异具有统计学意义(P<0.05),任意两项联合检测阳性率与任意单项联合检测阳性率虽有差异,但差异无统计学意义。结论血清标志物AFP、CEA、GGT联合检测可提高原发性肝癌的诊断率,对诊断原发性肝癌具有一定的临床应用价值。

血清AFP、CA199、GGT、ALP联检肝癌早期诊断价值

目的:探讨甲胎蛋白(AFP)、糖类抗原199(CA199)、谷氨酰转肽酶(GGT)和碱性磷酸酶(ALP)单独或联合检测对原发性肝癌(PHC)的早期诊断价值。方法:本研究为回顾性研究,筛选2016年-2019年本院87例原发性肝癌(PHC)患者、105例慢性乙肝患者及104例健康志愿者,收集不同组首次入院和体检外周血检测数据和其他临床资料。比较各血清指标在组间差异性,分析了血清学指标与入组PHC临床分期和病理分型的相关性,进一步利用ROC曲线法分析血清指标单项与联合诊断的灵敏度、特异度。结果:AFP、CA199、GGT、ALP检测均值在PHC组均明显高于慢乙肝组和健康体检组。AFP阳性检测值与PHC临床分期(r=0.9536)和病理分型(r=0.525)呈正相关性。AFP诊断PHC灵敏度和特异性分别为60.87%和77.97%、精准度AUC为0.726。联合四项指标检测灵敏度、特异度和AUC分别为75.36%、65.64%、0.806。结论:AFP、CA199、GGT、ALP四项指标联合检测可提高原发性肝癌早期诊断的准确率,操作性强且易于推广。

γ-谷氨酰转肽酶/血小板计数比值对接受一线化疗方案的Ⅲ-Ⅳ期胃癌患者的预后价值

目的 探讨γ-谷氨酰转肽酶(γ-gamma-glutamyl transpeptidase, GGT)/血小板计数(Platelet, PLT)比值(γ-glutamyl transpeptidase to platelet ratio index, GPRI)对接受一线化疗方案的Ⅲ-Ⅳ期胃癌患者预后的预测价值。方法 选择138例非手术治疗的Ⅲ-Ⅳ期胃癌患者为研究对象,采集患者化疗前外周静脉血,检测GGT水平及PLT,根据公式GPRI=GGT/PLT(×109/L),计算不同患者的GPRI值。以GPRI>0.39为界值,将患者分为高GPRI组及低GPRI组。对患者进行连续性随访,采用卡方检验分析患者临床病理参数对GPRI比值的影响;利用Kaplan-Meier法及Log-rank检验分析GPRI比值对患者预后的影响。结果 (1)受试者工作特征(Receiver operating characteristic,ROC)曲线分析显示,GPRI、GGT、PLT的最佳临界值分别为0.39、64.68和178.59,ROC曲线下面积(Area under curve,AUC)分别为0.776、0.659和0.705,GPRI判断患者预后的效能明显优于单独检测GGT和血小板。(2)与低GPRI组相比,高GPRI组患者中>1器官转移及腹膜转移发生率、Ⅳ期患者比例、糖苷类肿瘤标志物(CA19-9)>37 U/mL的患者比例均明显较高(P<0.05)。且>1个器官转移(P=0.002)、腹膜转移(P=0.024)、Ⅳ期(P=0.008)、CA19-9水平(P=0.004)和GPRI>0.39(P=0.033)均是影响患者中位无进展生存期(Progression free survival, PFS)和中位总生存期(Overall survival, OS)的独立性危险因素。(3)所有患者的OS及PFS分别为156 d和217 d。低GPRI组、高GPRI组患者的中位PFS分别为202 d、117 d;中位OS分别为269 d、173 d,差异均有统计学意义(P均<0.05)。进一步行亚组分析发现,在转移器官>1个(χ^(2)=18.24,P<0.01)、Ⅳ期(χ^(2)=19.85,P<0.01)和CA19-9水平升高(χ^(2)=12.65,P<0.01)的亚组患者中,低GPRI组患者的OS均明显好于高GPRI组。结论 GPRI对接受一线化疗方案的Ⅲ-Ⅳ期胃癌患者的预后有较高的预测价值,有望作为晚期胃癌患者的一项新的预后指标。

γ-谷氨酰转肽酶与嗜酸性粒细胞联合B超检查对肝吸虫病的诊断价值

目的探讨γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)与嗜酸性粒细胞(eosinophils,EOS)等检验指标联合B超检查对肝吸虫病的诊断价值。方法选取粪便寄生虫检查找到肝吸虫卵的病例175例为观察组,另选取同期肝吸虫抗体检测及粪便寄生虫卵检查均阴性的健康体检人员171例为对照组。分析比较两组间总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、GGT、EOS及B超检查结果的差异,筛选出有统计学意义的检查指标,运用logistic回归分析建立肝吸虫病联合诊断模型。结果两组GGT和EOS比较差异有统计学意义(P<0.001)。两组间B超检查结果对比,观察组胆囊病变、胆管病变以及肝脏病变分别为31例(17.7%)、36例(20.6%)、70例(40.0%);对照组胆囊病变、胆管病变以及肝脏病变分别为11例(6.4%)、3例(1.8%)、64例(37.4%)。经逐步回归分析,GGT、EOS、胆囊异常、胆管异常4项指标入选模型。GGT与EOS联合B超检查建立回归方程,得到联合诊断模型logitP。logitP的受试者工作特性曲线(receiver operator characteristic curve,ROC)的曲线下面积(the area under curve,AUC)为0.784,敏感性为0.669,特异性为0.801。结论GGT和EOS联合B超检查在肝吸虫病诊断中具有较好的诊断效能。

Gamma-glutamyl Transpeptidase to Platelet Ratio Predicts Liver Injury in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients With Normal Alanine Aminotransferase

Background and Aims:Chronic hepatitis B virus(HBV)infection is a serious health problem worldwide.Evaluating liver injury in patients with hepatitis B e antigen(HBeAg)-negative chronic hepatitis B(CHB)with detectable HBV DNA and normal alanine aminotransferase(ALT)is crucial to guide their clinical management.We aimed to investigate the stages of liver inflammation and fibrosis as well as the predictive accuracy of gamma-glutamyl transpepti-dase-to-platelet ratio(GPR)in these patients.Methods:A total of 184 treatment-naïve HBeAg-negative CHB pa-tients with detectable HBV DNA and normal ALT were enrolled.The Scheuer scoring system was used to classify liver inflammation and fibrosis.Results:The distribution of patients with different liver inflammation grades were as follows:G0,0(0%);G1,97(52.7%);G2,68(37.0%);G3,12(6.5%);and G4,7(3.8%).The distribution of patients with different liver fibrosis stages were as follows:S0,22(12.0%);S1,72(39.1%);S2,42(22.8%);S3,19(10.3%);and S4,29(15.8%).The areas under the re-ceiver operating characteristic(AUROC)curves of GPR in predicting significant inflammation,severe inflammation,and advanced inflammation were 0.723,0.895,and 0.952,respectively.The accuracy of GPR was significantly superior to that of ALT in predicting liver inflammation.The AUROCs of GPR in predicting significant fibrosis,severe fibrosis,and cirrhosis were 0.691,0.780,and 0.803,respectively.The predictive accuracy of GPR was significantly higher than that of aminotransferase-to-platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4)in identifying advanced fibrosis and cirrhosis,and it was superior to FIB-4 but comparable to APRI in identifying significant fibrosis.Conclusions:Nearly half of the HBeAg-negative CHB patients with detectable HBV DNA and normal ALT levels had significant liver inflammation or fibrosis.GPR can serve as an accurate predictor of liver inflammation and fibrosis in these patients.

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Background and aim:Coronavirus disease 2019(COVID-19)is a life-threatening disease that predomi-nantly causes respiratory failure.The impact of COVID-19 on other organs remains elusive.Herein,we aimed to investigate the effects of COVID-19 on the hepatobiliary system.Methods:In the current study,we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February 2020.The detailed clinical features and laboratory findings were collected for analysis.Bioinformatics analysis was conducted to evaluate the correlation between gamma-glutamyl transferase(GGT)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry receptor angiotensin-converting enzyme 2(ACE2).Results:In this cohort,30(51.7%)patients had abnormal liver function on admission,which was asso-ciated with disease severity and enriched in the male and diabetic patients.The elevated levels of direct bilirubin(P¼0.029)and GGT(P¼0.004)were common in patients with severe pneumonia when compared with those with mild pneumonia.In addition,elevated levels of GGT(P¼0.003)and aspartate aminotransferase(AST)(P¼0.007)were positively associated with longer hospital stay.The expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1 b(HNF1B).Conclusions:Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease severity.Due to the consistent expression with ACE2,GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.

四种肿瘤标志物在原发性肝癌诊断中的应用价值

目的:探讨肿瘤标志物甲胎蛋白(AFP)、L-岩藻糖苷酶(AFU)、谷氨酰转肽酶(GGT)、5′-核苷酸(5′-NT)在原发性肝癌(PHC)诊断中的应用价值。方法:110例分为2组,PHC组70例,正常对照组40例,采用电化学发光仪检测2组血清AFP水平,采用LX-20型生化仪检测2组AFU、GGT、5′-NT水平,并分析4种肿瘤标志物对PHC的诊断价值。结果:PHC组血清AFP、AFU、GGT、5′-NT水平均明显高于正常对照组,差异有统计学意义(P<0.05-0.01)。AFP、GGT、5′-NT、AFU对PHC诊断的敏感性分别为71.42%、68.57%、32.86%、21.43%,AFU、GGT、5′-NT检测的特异性均为100.00%,AFP检测特异性为95.00%,4种血清肿瘤标志物联合检测敏感性为92.85%。结论:肿瘤标志物AFP、AFU、GGT、5′-NT对PHC有一定的诊断价值,4种肿瘤标志物联合检测可提高诊断PHC的敏感性。

肝功能指标在早期慢性苯中毒机体损伤中的价值研究

目的观察慢性苯中毒患者的肝功能指标水平,探讨其早期判断慢性苯中毒肝功能损害的价值,为临床精准监测慢性苯中毒机体损伤的发生及其早期干预提供循证医学证据。方法选取48名职业性慢性苯中毒患者,根据《职业性苯中毒诊断标准(GBZ 68-2013)》分为轻度组、中度组、重度组,50名健康体检人群做为对照组,分析指标包括ALT、AST、ALP、GGT、TBIL、DBIL、IBIL、TP、ALB和GLB等常规肝功能生化指标。结果单因素方差分析显示各组间ALT(P=0.000)、AST(P=0.000)、ALP(P=0.001)、GGT(P=0.000)、TBIL(P=0.008)和ALB(P=0.000)总体差异有统计学意义。组内分析示各组间ALT、AST、ALP、TBIL均有统计学差异,且和中毒程度具有相关性,提示ALT、AST、ALP、TBIL在苯中毒肝功能损伤中具有更高敏感性。结论ALT、AST、ALP和TBIL可成为辅助诊断早期慢性苯中毒机体损伤的实验室指标。

早期原发性肝癌患者谷氨酰转肽酶、高尔基体糖蛋白及甲胎蛋白变化的临床研究

目的探讨谷氨酰转肽酶（GGT）、高尔基体糖蛋白（GP73）、甲胎蛋白（AFP）联合诊断早期原发性肝癌的价值,为临床相关诊断提供参考.方法选取本院于2015年11月至2017年11月收治的原发性肝癌患者218例,另选取同期收治的152例肝硬化患者,140例健康体检者作为对照组.对比3组受试者GGT、GP73、AFP含量及各指标特异度及灵敏性,并进行ROC曲线分析.结果原发性肝癌组血清GGT、GP73、AFP含量均高于肝硬化组及对照组,且肝硬化组血清GGT、GP73、AFP含量均高于对照组,差异均有统计学意义（P〈0.05）;ROC曲线图显示,AFP曲线下面积0.84、GGT曲线下面积0.77、GP73曲线下面积0.72,AFP、GGT、GP73三者联合诊断曲线下面积0.94.3项联合诊断的灵敏度及特异度高于AFP、GGT、GP73单项诊断.结论早期原发性肝癌患者血清AFP、GGT、GP73含量升高,且3项指标联合诊断具有较高的灵敏度和特异度,值得临床借鉴.

急性髓系白血病患者血清腺苷脱氨酶测定的意义

目的探讨血清腺苷脱氨酶(ADA)在急性髓系白血病(AML)的变化规律及其意义。方法收集山东省立医院2012年1月至2013年12月75例治疗前急性髓系白血病患者(其中63例AML患者进行自身治疗前后比较)和86例健康对照者外周血血清。采用PNP-XTO-POD偶联连续监测法测定血清腺苷脱氨酶(ADA)水平,采用速率法测定谷草转氨酶(AST)、谷丙转氨酶(ALT)和谷氨酰转肽酶(GGT)水平。检测健康对照组与AML组血清ADA水平,比较AML治疗前后ADA水平变化,采用受试者工作特征曲线(ROC曲线)确定ADA最佳截点,并将AML治疗前患者分为低ADA组(ADA<13.50 U/L)和高ADA组(ADA≥13.50 U/L),分析两组间年龄、性别、AST、ALT和GGT差异。结果 AML组患者ADA水平[15.30(9.50,31.30)U/L]显著高于健康对照组[8.45(7.05,11.35)U/L],差异有统计学意义(P<0.001);AML组治疗后ADA水平[10.70(8.10,14.90)U/L]显著低于AML治疗前[14.70(9.60,26.70)U/L],差异有统计学意义(P<0.001);采用ROC曲线,将AML治疗前患者分为高ADA组(ADA≥13.50 U/L)和低ADA组(ADA<13.50 U/L),其中高ADA组中AST、ALT及GGT水平显著高于低ADA组(AST Z=-3.102,P=0.002;ALT Z=-2.046,P=0.041;GGT Z=-2.794,P=0.005)。结论 ADA检测可以作为AML患者的一项常规辅助检查,对AML的疾病诊断及评估病情的发展具有一定的价值。

Nonalcoholic steatohepatitis in nonalcoholic fatty liver disease patients of Bangladesh

AIM: To explore the prevalence and risk factors for nonalcoholic steatohepatitis (NASH) in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: We have included 493 patients with sonographic evidence of a fatty change, and 177 of these individuals were evaluated and confirmed after liver biopsy. The exclusion criteria consisted of significant alcohol abuse (【 20 g daily), evidence of hepatitis B and C, evidence of drug-induced fatty liver disease and other specific liver diseases such as hemochromatosis, Wilson’s disease or autoimmune liver disease. The patients were assessed for metabolic syndrome, and biochemical, anthropometric and histopathological evaluations were carried out. The degree of disease activity in the NAFLD patients was evaluated using the NAFLD Activity Score. The data were analyzed by SPSS, version 16.0. RESULTS: Females predominated among the study participants (250, 57.0%), and the mean age was 40.8 ± 10.2 years. The numbers of overweight, obeseⅠ and obese Ⅱ patients were 58 (13.2%), 237 (53.9%) and 93 (21.2%), respectively. However, there were 422 (96.2%) centrally obese patients. NASH was absent in 10 (5.6%) cases, borderline in 92 (52.6%) cases and present in 75 (42.4%) cases. The presence of diabetes could significantly (P = 0.001) differentiate NASH from simple steatosis. The following parameters did not influence the development of NASH: age, sex, basal metabolic index, waist circumference, serum high-density lipoprotein, triglyceride, insulin resistance index, hypertension and metabolic syndrome. The serum gammaglutamyl transpeptidase (GGT) level was significantly higher (P = 0.05, 51.7 ± 32.8 and 40.4 ± 22.6 U/L) in the NASH patients, with a sensitivity of 45% and a specificity of only 68%. The serum alanine aminotransferase and aspartate aminotransferase levels were not able to predict NASH. CONCLUSION: Females were the predominant sufferers of NAFLD in Bangladesh. The prevalence of NASH was high. Diabetes was found to be the main culprit in developing NASH. GGT was the only biochemical marker of NASH. We recommend liver biopsy in NAFLD patients who have diabetes and elevated GGT.

Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study

BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver.METHODS:We investigated the clinical and laboratory data of 669 patients with fatty liver.Of the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol consumption.We further analyzed the relationship between alcohol consumption and clinical characteristics of these patients.RESULTS:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P<0.05).In the patients without long-term alcohol consumption,the values of GGT and hemoglobin in patients with light alcohol consumption were significantly higher than those in non alcohol consumers (P<0.05).CONCLUSION:Alcohol consumption is associated with significantly increased values of AST,GGT,and hemoglobin in patients with fatty liver,suggesting their potential roles in hepatic steatosis.

大鼠肝癌发生过程中卵圆细胞分化的双染色研究

用r`谷氨酰转肽酶-甲胎蛋白(GGT-AFP)双染色法,对F_344大鼠肝癌发生过程中卵圆细胞的分化进行研究.结果表明,与免疫酶双标记法相比,此法具有特异性高、简便、精确、易于观察、经济、易推广等优点。卵圆细胞GGT 阳性,AFP 阴性;过渡细胞GGT,AFP 双表达;小肝细胞AFP 阳性,胆管细胞GGT 阳性。提示卵圆细胞是一种具有分化潜能的干细胞,过渡细胞双表达是处于双向分化状态,表达AFP 可以分化成小肝细胞,表达GGT 可以分化成胆管细胞。

Silymarin in non alcoholic fatty liver disease

AIM: This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD). METHODS: In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment. RESULTS: Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped. CONCLUSION: The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered.

联合检测血清肿瘤标志物对原发性肝癌患者诊断和治疗的临床应用价值

目的:探讨肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、CA199、谷氨酸氨基转肽酶(GGT)联合检测对原发性肝癌(PHC)患者诊断及治疗的临床意义。方法:应用化学发光法及全自动生化分析仪对80例原发性肝癌患者和50例肝病患者及70例健康体检者进行AFP、CEA、CA199、GGT检测。结果:原发性肝癌组AFP、CEA、CA199、GGT各项指标均显著高于肝病组和健康体检组,差异具有统计学意义(P<0.01)。联合检测的灵敏度和特异度分别为94.61%、80.75%,与单项检测比较阳性率明显增高,差异具有统计学意义(P<0.05)。结论:血清AFP、CEA、CA199、GGT联合检测可提高原发性肝癌诊断的敏感性,对早期诊断原发性肝癌具有一定的临床应用价值。