Role of the criteria based on preoperative serological indexes of AFP and GGT in predicting long-term survival of patients with hepatocellular carcinoma after liver transplantation / 器官移植

Objective To evaluate the role of preoperative serological indexes in predicting long-term survival and tumor recurrence of hepatocellular carcinoma (HCC) patients after liver transplantation, aiming to explore its significance in expanding the Milan criteria. Methods Clinical data of 669 recipients undergoing liver transplantation for HCC were retrospectively analyzed. The optimal cut-off value was calculated by the receiver operating characteristic (ROC) curve. The risk factors affecting the overall survival and recurrence-free survival rates of HCC patients after liver transplantation were identified by univariate and multivariate regression analyses. The correlation between preoperative serum liver enzymes and pathological characteristics in HCC patients was analyzed. The predictive values of alpha-fetoprotein (AFP) combined with γ -glutamyl transferase (GGT) and different liver transplant criteria for the survival and recurrence of HCC patients after liver transplantation were compared. Results Exceeded Milan criteria, total tumor diameter (TTD) > 8 cm, AFP > 200 ng/mL and GGT > 84 U/L were the independent risk factors for the overall survival and recurrence-free survival rates of HCC patients after liver transplantation (all P < 0.05). Correlation analysis showed that preoperative serum GGT level was correlated with TTD, number of tumor, venous invasion, microsatellite lesions, capsular invasion, tumor, node, metastasis (TNM) stage, Child-Pugh score and exceeded Milan criteria (all P < 0.05). Milan-AFP-GGT-TTD (M-AGT) criteria were proposed by combining Milan criteria, TTD with serum liver enzyme indexes (AFP and GGT). The 5-year overall survival and recurrence-free survival rates of HCC recipients who met the M-AGT criteria (111 cases of exceeded Milan criteria) were significantly higher than those who met Hangzhou criteria (both P < 0.05), whereas had no significant difference from their counterparts who met the University of California at San Francisco (UCSF) criteria (both P > 0.05). Conclusions Preoperative serological indexes of AFP and GGT could effectively predict the long-term survival and tumor recurrence of HCC patients after liver transplantation. Establishing the M-AGT criteria based on serological indexes contributes to expanding the Milan criteria, which is convenient and feasible.

Correlation between GPR, MHR and elderly essential hypertension with unstable angina pectoris / 中南大学学报(医学版)

OBJECTIVES@#To investigate the level and significance of serum γ-glutamyl transferase-to-platelet ratio (GPR) and monocyte count to high-density lipoprotein ratio (MHR) in patients with essential hypertension (EH) and unstable angina (UA).@*METHODS@#A total of 218 patients with coronary angiography aged ≥60 years, who were admitted to the EH hospital of the Department of Cardiac Medicine, Affiliated Hospital of Chengde Medical College, were selected from September 2018 to September 2019. They were divided into an EH+UA group (@*RESULTS@#Compared with the control group, patients in the EH+UA group and the EH group had higher body mass index (BMI), tyiglyceride (TG), GPR, and MHR, and lower high-density lipoprotein-cholesterol (HDL-C) (all @*CONCLUSIONS@#There is a correlation between GPR, MHR and EH combined with UA pectoris, and the combined detection of the two indicators has adjuvant diagnostic value for elderly EH combined with UA.

Application value of ultrasound elastography in evaluating liver elasticity of stable recipients at different stages after liver transplantation / 器官移植

Objective To explore the value of ultrasound elastography in the non-invasive monitoring of liver elasticity of stable recipients at different stages after liver transplantation. Methods Clinical data of 73 stable recipients after liver transplantation were collected. According to the time after liver transplantation, all patients were divided into the early group (n=25) and medium-to-long group (n=48). In addition, 38 healthy subjects were assigned into the control group. The ultrasound indexes and liver function indexes were statistically compared among each group. The ultrasound elastography indexes of liver and spleen were analyzed, and their correlation with liver function indexes was analyzed. Results Compared with the control group, the ultrasound indexes, alanine aminotransferase (ALT), γ-glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels were significantly increased in the early group (all P < 0.05), and the ultrasound indexes in the medium-to-long group were significantly increased, whereas the GGT level was significantly decreased (all P < 0.05). Compared with the early group, the right oblique diameter of liver, ALT, GGT and ALP levels were significantly decreased in the medium-to-long group (all P < 0.05). Compared with the control group, the sound touch elastography (STE) and sound touch quantify (STQ) values of liver and STE value of spleen in the early group and medium-to-long group were significantly increased (all P < 0.05). Compared with the early group, the ultrasound elastography indexes of liver and spleen in the medium-to-long group were remarkably decreased (all P < 0.05). The ultrasound elastography indexes of liver were weakly correlated with the ALT, aspartate aminotransferase (AST) and GGT levels, significantly correlated with ALP level. The STE value of spleen was weakly correlated with the ALP level. The STE value of liver was significantly correlated with the STQ value of liver. The STE and STQ values of liver were weakly correlated with the STE value of spleen. Conclusions The characteristics of liver elasticity in stable recipients after liver transplantation are various among different stages. Persistent monitoring of liver elasticity may provide a novelnon-invasive monitoring method during follow-up after liver transplantation.

Clinical value of serum VEGF,GGT and sTREM-1 in early COPD / 国际检验医学杂志

Objective To explore the clinical value of serum vascular endothelial grow th factor(VEGF), γ-glutamyl transferase(GGT)and soluble myeloid cell trigger receptor-1(sTREM-1)in early chronic obstruc-tive pulmonary disease(COPD).Methods 30 cases of COPD patients admitted from February 2013 to Febru-ary 2015 were selected as the observation group,and 30 healthy subjects were selected as the control group. The levels of serum VEGF,GGT and sTREM-1 were compared between the two groups.Results The levels of serum VEGF,GGT and sTREM-1 were significantly decreased in the observation group after treatment,the difference was statistically significant(P<0.05).The levels of serum VEGF,GGT and sTREM-1 in the obser-vation group were significantly higher than those in the control group(P<0.05).The serum VEGF,GGT and sTREM-1 were respectively detected under the ROC curve area was 0.83,0.80,0.67,specificity and sensitivi-ty were 73.3%,71.1%,58.9% and 91.3%,88.6%,80.2%.ROC curve area of combined detection of VEGF, and GGT in early diagnosis of COPD was 0.94,the sensitivity and specificity were 81.3% and 96.4%;ROC curve area of combined detection of VEGF,and sTREM-1 in early diagnosis of COPD was 0.89,the sensitivity and specificity were 75.5% and 92.8%.Conclusion Serum VEGF,GGT,sTREM-1 level can be used as an important monitoring index for early diagnosis of COPD.

Diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones / 中华消化外科杂志

Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.

The association between serum γ-glutamyl transferase and the dynamics of prealbumin/model for end stage live disease in patients with liver failure caused by hepatitis B virus / 中华传染病杂志

Objective To investigate the serum γ-glutamyl transferase(γ-GT)level and its clinical significances in hepatitis B virus(HBV)-liver failure(LF)patients.Methods γ-GT levels were detected in 89 LF patients,30 cases with cirrhosis and 30 healthy controls.Difference of serum γ-GT between survival group and death group in LF patients and dynamics of γ-GT after hospitalization were studied. Survival rate between γ-GT increase group and decrease group were compared.The associations of γ-GT with model for end stage live disease(MELD)and prealbumin were calculated.Results At baseline,the γ-GT levels in LF,cirrhosis and healthy control groups were(149.61 ± 69.86),(123.96 ± 59.52)and (48.28 ± 10.25)U/L,respectively,the difference among groups was significant(F= 178.150,P<0.05).The survival group in LF patients showed significant increase of γ-GT one week after hospitalization compared with death group([75.27 ± 10.34]vs[29.47 ± 5.05],t=5.40,P<0.05). The γ-GT increase group showed higher survival rate than γ-GT decrease group[76.19%(48/63)vs 23.08%[6/26],χ2=21.76,P<0.05].Serum γ-GT level in LF patients was positively correlated with both MELD score and prealbumin(r=0.709 and -0.627,respectively,both P<0.05).Conclusions The rise of γ-GT may indicate a better prognosis in LF patients.Serum γ-GT positively correlates with prealbumin and both could reflect the regeneration of hepatocytes.

Study on the application value of aspartate aminotransferase mitochondrial isoenzyme in patients with alcoholic liver disease / 国际检验医学杂志

Objective To analyse the clinical value of aspartate aminotransferase mitochondrial isoenzyme (m‐AST ) determina‐tion in patients with alcoholic liver disease .Methods 61 cases of patients with alcoholic liver disease (observe group) receiving treatment in this hospital from March 2013 to March 2015 and 61 cases of healthy individuals(control group) were enrolled in this study ,and serum levels of m‐AST ,alanine amino transferase(ALT) ,aspartate amino transferase(AST) and γ‐glutamyl transferase (GGT) were detected .Results Compared with the control group ,serum levels of of m‐AST ,ALT ,AST and GGT were increased in the observe group ,there were statistically significant differences (P<0 .05) .In patients with alcoholic liver disease ,after treatment , serum levels of m‐AST ,ALT ,AST and GGT were different among patients with hepatic adipose infiltration ,patients with hepatitis and patients with liver cirrhosis ,there were statistically significant differences(P<0 .05) .Conclusion Combined with ALT ,AST and GGT ,m‐AST could be utilized as an indicator for diagnosing alcoholic liver disease ,which has clinical significance .

In vitro Antioxidant/ Radical Scavenging Activities and Hepatoprotective Roles of Ethanolic Extract of Cassia occidentalis Leaves in Sodium Arsenite-Treated Male Wistar Rats.

Aims: To investigate in vitro antioxidant/radical scavenging activities and hepatoprotective ability of ethanolic leaf extracts of Cassia occidentalis (COLEX) in male Wistar rats treated with sodium arsenite (NaAsO2). Study Design/Methodologies: Using four different methodologies, the anti-oxidant/free radical scavenging activities of COLEX were determined in comparison with standard antioxidants, butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT). For the hepatoprotection study, four groups of rats were used. Groups A: Control group given distilled water only; B: Given NaAsO2 at 2.5 mg•kg-1 bw/day (p.o.) for 2 weeks; C: Administered COLEX alone at 200 mg•kg-1 bw a day for 2 weeks (p.o.); D: Pre-treated with COLEX for 2 weeks followed by NaAsO2. The activities of the enzymes aspartate and alanine aminotransferases (AST and ALT), alkaline phosphatase (ALP) and γ- glutamyl transferase (γGT) were determined in the treated and control animals as indices of hepatotoxicity. Place and Duration of the Study: The animal treatment and analyses were carried out at Department of Biochemistry, University of Ibadan between February and June 2008. Results: At 25, 40 and 50 μg•ml-1 concentrations of the extracts or the antioxidants, the reducing power is of the order BHA > BHT > COLEX. At 50 μg•ml-1, the percentage inhibitions of peroxidation by COLEX, BHA and BHT were respectively 96.2%, 97.3% and 98.4% while percentage DPPH scavenging effect of COLEX, BHA and BHT were 62.5%, 67.5% and 61.3% respectively. The H2O2 scavenging activities were respectively 53.0%, 85.3% and 97.8% for COLEX, BHA and BHT. Pre-treatment with COLEX before administration of NaAsO2 led to significant (p < 0.05) reduction in the mean liver and serum γGT, and serum ALP and AST activities when compared with group administered only NaAsO2. Conclusion: COLEX exhibited hepatoprotective effects against NaAsO2 toxicity in male rats.

The analysis of correlation between the performance of HBV markers and AFU,ALT,GGT / 中国基层医药

Objective To investigate the correlation between hepatitis B virus(HBV)markers and AFU,ALT,GGT.Methods 570 eases of HBV-infected people were divided into 4 groups according to the different performance modes.150 healthy people were considered as control group.rate method was used to detect AFU,ALT and GGT.Estimate the differences between the groups were compared.Results The comparison between the AFU,ALT,GGT in different performance mode of HBV and the control group showed:the differences of group 1,group 2 and group 3 were statistically significant(P＜0.01),the difference of group 4 was not significant(P＞0.01).The correlation between AFU,ALT,GGT of different performance mode showed:the changes of AFU and ALT,GGT in group 1,group 2 and group 3 were positively change-related.But the changes of AFU,ALT and GGT were not clearly related.The distribution of the rise of serum enzyme activity in different performance mode showed:the AFU,ALT and GGT rised in different proportion in group 1,group 2 and group 3.Conclusions The AFU,ALT and GGT activity of HBVinfected persons should be detected at the same time,and evaluate the damage of liver cells.This will do help to predict the progression of hepatitis.