Diagnosit value of erythrocyte-free polyamines and histaminemia in malignant hepatic tumors and in liver cirrhosis

Abstract

The present study tries to evaluate the diagnosit value in malignant hepatic tumors of polyamines, of which the relationship with cellular kinetics is known, and histamine, of which catabolism follows a similar pathway. One hundred and fifty six patients were studied: 53 with malignant liver tumors (27 primary, 26 metastatic) and 103 with non-tumoral liver diseases of which 65 were cirrhotic and 38 non-cirrhotic. Erythrocyte polyamines (spermidine and spermine) and histamine levels were assayed. The results indicate the following. 1. Polyamine levels were significantly increased (a) in cirrhotic patients, not only when compared with controls ( p < 10 −8), but also when compared with the non-cirrhotic patients ( p < 10 −7); (b) in primary malignant hepatic tumors ( p < 10 −3). 2. Histamine was significantly increased (a) in the non-tumoral liver diseases ( p < 10 −4), but with no difference between cirrhotic and non-cirrhotic patients; (b) in the secondary malignant tumor patients, histamine levels were lower than in primary tumor patients ( p < 0.04). 3. There was no correlation, in all groups studied, between polyamine and histamine levels. These results suggest the following practical implications. 1. For non-tumor liver diseases, appreciably increased polyamine levels may represent a further argument favoring a cirrhotic condition. 2. In diagnosing hepatic scintigraphic defects, inbetween histamine and polyamines, are in favor of histamine synthesis. In the secondary malignant hepatic tumor group, histamine levels were low. sometimes considerably. Future studies, by estimating plasma diamine oxidase activity may he able to solve some of these questions. In conclusion, the evaluation of erythrocyte polyamine and histamine levels has two practical implications in hepatology. For non-tumor liver diseases, appreciably increased red blood cell polyamine levels may represent a further argument favoring a cirrhotic condition. In diagnosing hepatic scintigraphic defects, increased erythrocyte polyamine levels would suggest a primary malignant hepatic tumor; low histamine levels are more in favor of a secondary malignant hepatic process.