Combined detection of interleukin-6 and γ-glutamyltranspeptidase facilitates evaluation of therapeutic efficacy and prognosis of AFP-negative TACE-treated hepatocellular carcinoma patients / 解放军医学杂志

Objective To analyze the clinical value of combined detection of several serum markers in the treatment and prognosis of patients with alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). Methods A total of 120 patients (from September 2016 to March 2018) diagnosed with HCC followed by TACE are recruited in this study. Serum samples were collected and dynamic markers, serum AFP, carcinoembryonic antigen (CEA), carbohydrate antigen-199 (CA199), CA125, gamma-glutamyltranspeptidase (GGT), interleukin (IL)-2, IL-4, IL-6, IL-10, γ-interferon (IFN-γ), and tumor necrosis factor α (TNF-α) levels were detected in 44 AFP-negative patients and 76 AFP-positive patients prior, 1 and 3 months after TACE. During the follow-up period, the tumor activity of patients was monitored and the clinical value of different marker combinations on the efficacy and prognosis of AFP-negative HCC patients after TACE was analyzed until July 2018. Results There was no statistically significant difference in the pre-operative indicator levels between AFP-negative and AFP-positive patients (P>0.05). The sensitivity, specificity, negative predictive value, and positive predictive value of IL-6 combined with GGT in detecting the efficacy and prognosis of AFP-negative and AFP-positive patients were 95.2%, 87.0%, 87.0%, 95.2% and 85.7%, 59.6%, 70.1%, and 79.1%, respectively. The area under the ROC curve of IL-6 for the prognosis of AFP-negative and AFP-positive HCC patients was 0.839 and 0.666. Conclusion Serum IL-6 combined with GGT can be used as an effective indicator for predicting the efficacy and tumor activity of AFP-negative HCC patients after TACE.

Detailed Distribution of Liver Enzymes according to Gender, Age, and Body Mass Index in Health Check-up Subjects / 대한소화기학회지

BACKGROUND/AIMS: The aim of this study was to examine the distribution of range of liver enzymes according to age and BMI in each gender using large-scale data. METHODS: Data were gathered from 65,715 subjects who underwent a routine health check-up and did not have HBsAg and anti-HCV. Boxplot analysis was used to examine the distribution of range of liver enzymes according to age and BMI in each gender. Multivariate linear regression analysis was performed for assessment of the association of liver enzymes with age and BMI, and to determine whether the range of liver enzymes was affected by risk factors for metabolic syndrome in each gender. RESULTS: ALT, AST, and GGT levels showed significant association with BMI in both male and female after adjusting for age. The range of ALT, AST, and GGT levels varied more widely according to the increase in BMI in males than in females, and this finding was more prominent in younger subjects than in older subjects. All risk factors for metabolic syndrome were shown to affect liver enzyme levels in male subjects. However, although most risk factors for metabolic syndrome affected liver enzyme levels, there might be weak or no effect of fasting hyperglycemia on AST, and low serum HDL-cholesterol level on GGT in female subjects. CONCLUSIONS: Age, BMI, and other risk factors for metabolic syndrome had a significant effect on the distribution of range of liver enzymes in each gender, even in this study conducted from Korean health checkup subjects.

Purification and Characterization of Helicobacter pylori gamma-Glutamyltranspeptidase

Gamma-glutamyltranspeptidase (GGT) was purified to electrophoretic homogeneity from the cell extract of H. pylori. The purified enzyme consisted of heavy and light subunits with molecular weights of 38 kDa and 21 kDa, respectively. N-terminal amino acid sequence of heavy and light subunits revealed that H. pylori GGT was processed into 3 parts for a signal peptide of 27 amino acid residues, a heavy subunit of 352 residues, and a light subunit of 188 residues during translation. The reaction rate for hydrolysis of gamma-GpNA was 84.4 micromol/min per milligram of protein, and that for the gamma-glutamyl transfer from gamma-GpNA to gly-gly was 23.8 micromol/min per milligram of protein. The apparent Km values of H. pylori GGT for gamma-glutamyl compounds were on the order of 10-3 to 10-4 M and those for acceptor peptides and amino acids were on the order of 10-1 to 10-2 M. The GGT protein kept approximately 80% of the initial enzymatic activity on incubation at 60degrees C for 15 min. The optimum temperature and pH for reactions of both hydrolysis and transpeptidation were 40degrees C and 9.0, respectively. The transpeptidation and hydrolysis reactions catalyzed by H. pylori GGT were strongly inhibited by L-Gln and moderately inhibited by L-Ala, L-Ser, beta-chloro-L-Ala, and L-Glu. These results demonstrated that the biochemical properties of H. pylori GGT are different from those of other bacterial GGTs. Further, H. pylori GGT might degrade glutathione in the gastric mucous layer of humans if the enzyme could be secreted in the bacterial niches.

Alfa-fetoproteína y gamma-glutamiltranspeptidasa en pacientes con cirrosis hepática y carcinoma hepatocelular / Alpha-fetoprotein and gamma-glutamyltransferase in patients with liver cirrhosis and hepatocellular carcinoma

Introducción: El carcinoma hepatocelular (CHC) es una complicación de la cirrosis hepática (CH). El objetivo principal del estudio fue describir los niveles de los marcadores serológicos alfa-fetoproteína (AFP) y gamma-glutamiltranspeptidasa (GGT) en pacientes con CH y/o CHC. Métodos: Estudio de corte transversal con 99 pacientes con diagnóstico de CH y/o CHC. Resultados: Un total de 66 (66,7%) pacientes presentaban un diagnóstico de CH, 23 (23,2%) CHC asociado a CH y 10 (10,1%) CHC aislado. Los valores de AFP fueron mayores en individuos con CHC asociado a CH comparados con aquellos que solo tenían CH (20 y 2,93 ng/mL, p<0.05); los niveles de la GGT fueron también mayores en pacientes con CHC asociado a CH (208 y 109 UI/L, p<0,05). Ningún paciente con CHC tuvo en forma simultánea valores normales de AFP y GGT. Conclusiones: En pacientes con CHC asociado a CH los niveles de AFP y GGT son significativamente más altos que individuos con CH aislada.

Introduction: Hepatocellular carcinoma (HCC) is one of the complications associated with liver cirrhosis (LC). The main objective of the present study was to describe the levels of the serological markers alpha-fetoprotein (AFP) and gamma-glutamyltranspeptidase (GGT) in patients with LC and/or HCC. Methods: Cross sectional study that included 99 patients with a diagnosis of LC and/or HCC. Results: 66 (66.7%) patients had a diagnosis of LC, 23 (23.2%) had LC alongside with HCC and 10 (10.1%) had HCC without LC. AFP levels were higher in individuals with HCC associated with LC when compared with those with LC only (20 and 2.93 ng/mL, p <0.05), the levels of GGT were also higher in patients with HCC associated with LC (208 and 109 IU/L, p <0.05). Not a single patient with HCC had normal levels of AFP and GGT simultaneously. Conclusions: In patients with HCC associated with LC levels of AFP and GGT were significantly higher than those found in individuals with LC only.