[Changes in plasma lipids and lipoproteins in chronic liver diseases]. / Studio delle alterazioni dei lipidi e delle lipoproteine plasmatiche nelle epatopatie chroniche.

In 214 patients with different chronic liver diseases and in 31 controls the plasma lipids (total and esterified cholesterol, HDL cholesterol, triglycerides) and lipoproteins have been evaluated. The liver patients were classified not only according to traditional diagnostic criteria, but also using a functional classification based on the evaluation of biosynthetic alteration and cholestatic damage, separately assessed in all patients. Parenchimal liver diseases and cholestatic diseases show different and specific plasma lipids and lipoprotein abnormalities. In parenchimal diseases (notably cirrhosis) a reduction of the plasmatic level of total, esterified and HDL cholesterol, without significant changes of triglycerides and lipoproteins was observed. As documented by functional classification, the reduction of total and esterified cholesterol correlates significantly with the degree of biosynthetic alteration. This finding may be related to the reduced hepatic cholesterol synthesis, probably associated with a decreased serum activity of the lecithin cholesterol acyl transferase (LCAT), due to impaired hepatic enzyme synthesis.

[Assay of the carcinoembryonic antigen (CEA) in acute and chronic liver diseases and hepatocellular carcinoma]. / Comportamento dell'antigene carcinoembrionale (CEA) nelle epatopatie acute e croniche e nel carcinoma epatocellulare.

Carcinoembryonic antigen (CEA) has been studied with a radioimmunoassay technique with an antiserum obtained from hepatic metastases of colonic cancer (Sorin Biomedica, Saluggia). The normal range of seric CEA varies from 0 to 10 ng/ml; 10 ng/ml is the higher value found in a smoker healthy subject. Seric CEA than 10 ng/ml has been found in 27% of cirrhoses, 39% of acute viral hepatitis (HBsAg+), 13.3% of chronic active hepatitis, 7.7% of chronic persistent hepatitis, 36% of alcoholic hepatitis and 100% of hepatomas. The diminished hepatic clearance of the antigen, or the derepression of its regulator gene, or the formation of CEA-like substances may cause the increase of seric CEA in hepatic diseases. The antiserum obtained from hepatic metastases of colonic carcinoma may explain the positivity in all the patients with hepatoma.