Abstract
γ-glutamyl transferase isoenzyme II (GGT-II) is a sensitive biomarker of hepatocellular carcinoma (HCC). However, numerous disadvantages of the traditional manual method affected its application. The commercial kit provided a convenient and fast method for the determination of GGT-II levels. The purposes of the present study were to compare the reproducibility and sensitivity between the manual and commercial kit methods and to evaluate the diagnostic efficiency for HCC with the combined analysis of GGT-II, α-L-fucosidase (AFU) and α-fetoprotein (AFP). In patients with various liver diseases (HCC, liver cirrhosis and chronic hepatitis) and normal subjects, GGT-II was detected by manual and commercial polyacrylamide gel electrophoresis (PAGE). The levels of AFU and AFP were assayed by colorimetry and a chemiluminescence immunoassay, respectively. The commercial PAGE had equal diagnostic efficiency with traditional manual PAGE and no significant differences were observed in intra- and average-gel reproducibility and GGT-II sensitivities between the manual and commercial PAGE (P>0.05). The incidence of GGT-II detected by commercial PAGE in HCC patients was 84.1% and <8% in benign liver disease. The levels of AFU and AFP in the benign liver diseases and normal subjects were lower than those in HCC. According to the cut-off value obtained by receiver operating characteristic curves, a total of 56.6 and 59.3% of HCC patients (64 out of 113 and 67 out of 113) had AFU >636.5 μmol/l h and AFP >44.0 μg/l, respectively. There were no significant correlations between GGT-II and AFU or AFP. Combined detection of GGT-II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial PAGE provides a simple and reproducible method for GGT-II detection. Combined determination of GGT-II with AFU or AFP exhibited superior sensitivity and specificity for the diagnosis of HCC.
Highlights
Hepatocellular carcinoma (HCC) is the second and the fifth most frequent type of cancer in China and the world, respectively
Combined detection of GGT‐II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial polyacrylamide gel electrophoresis (PAGE) provides a simple and reproducible method for GGT‐II detection
The level of AFP has been widely established as a classic HCC marker, but an elevated AFP level is observed in certain benign liver diseases and other malignancies
Summary
Hepatocellular carcinoma (HCC) is the second and the fifth most frequent type of cancer in China and the world, respectively. HCC is highly malignant and metastasizes readily at the early stages and its prognosis depends mainly on early diagnosis. Imaging (BUS, CT, MRI) and the detection of serum tumor markers are fundamental methods of identification in asymptomatic patients with HCC. In terms of serum markers, α‐fetoprotein (AFP) is the preferred serum marker for the diagnosis and monitoring of HCC but it is negative in ~40% patients with early stage HCC. Even in advanced HCC, the concentrations of AFP may be normal in 15‐30% of patients [5]. Additional HCC markers, including γ‐glutamyl transferase isoenzyme II (GGT‐II), α‐L‐fucosidase (AFU), Golgi protein‐73 (GP73) and transforming growth factors α and β (TGF‐α and TGF‐β), have been used to elevate the diagnostic sensitivity, specificity and early detection levels. There is no absolute positive and universal diagnostic marker for HCC. It is suggested that markers be simultaneously evaluated in order to enhance the detection of HCC [6,7,8]
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