Gamma-glutamyltranspeptidase levels as an aid in the management of human cancer

Sahm, Daniel F.; Murray, J. G.; Munson, Peggy L.; Nordquist, Robert E.; Lerner, Michael

doi:10.1002/1097-0142(19831101)52:9<1673::aid-cncr2820520921>3.0.co;2-u

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…Increased liver alkaline phosphatase activity in plasma is well recognised in hyperthyroid patients and was observed by Rhone et al in 73% of 42 hyperthyroid women. 4 Intraindividual variation of plasma alkaline phosphatase activity is significantly less than population (interindividual) variation. Consequently, the upper limit of a population reference range (even that derived from a population with benign breast disease) is relatively insensitive as a diagnostic "cut off" limit to detect a pronounced increase in enzyme activity.…”

Section: Discussionmentioning

confidence: 99%

Identification of bone and liver metastases from breast cancer by measurement of plasma alkaline phosphatase isoenzyme activity.

Mayne¹,

Thakrar²,

Rosalki³

et al. 1987

J Clin Pathol

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SUMMARY Plasma alkaline phosphatase isoenzyme activities were determined in patients with breast cancer to diagnose and monitor bone and liver metastases. Bone alkaline phosphatase activity was increased in 21 of 50 patients (42%) with radiologically confirmed bone metastases, while total alkaline phosphatase activity was increased in only 10 of 50 (20%); liver alkaline phosphatase activity was raised in 12 of 25 patients (48%) with liver metastases. All patients with liver metastases had bone metastases. Bone alkaline phosphatase activity was significantly higher in patients with symptomatic bone disease. Isoenzyme determination provided additional information that would have changed patient management in five of 20 patients who were monitored serially. Measurement of alkaline phosphatase isoenzyme activity, though less sensitive than imaging procedures, can assist in screening for, and in early detection of, a high proportion of bone and liver metastases, and can provide useful objective evidence of their response to treatment.More than 50% of patients with breast cancer develop overt bone metastases and many of these subsequently develop liver metastases.' Survival from breast cancer may be improved by early detection of metastases, as their treatment is usually reserved for symptomatic or progressive disease. The detection of micro or occult metastases is less important as, at present, this finding rarely changes treatment. Bone scintigraphy is a sensitive diagnostic procedure for the detection of overt bone disorders but it is not specific for metastases, and a positive scintigram may require confirmation by radiographical skeletal survey.2 These investigations, when performed during follow up to monitor disease, are costly, time consuming, and entail a radiation hazard. Perez et al3 claimed that it is possible to identify 95% of patients who develop bone metastases by clinical examination, chest x-ray, and measurement of plasma total alkaline phosphatase (ALP, EC 3.1.3.1) and y-glutamyltransferase (GGT, EC 2.3.2.2) activities. Although easy to perform and inexpensive, neither of the biochemical investigations unequivocally identifies the site of metastases deposits. Increased plasma total alkaline phosphatase activity can result

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Section: Discussionmentioning

confidence: 99%

Identification of bone and liver metastases from breast cancer by measurement of plasma alkaline phosphatase isoenzyme activity.

Mayne¹,

Thakrar²,

Rosalki³

et al. 1987

J Clin Pathol

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“…A change in the membrane enzyme y-glutamyltransferase activity is associated with malignant disease, and monitoring the y-glutamyltransferase activity as a possible indicator of malignant activity has been discussed (4,25,26). We could demonstrate increased activity for this enzyme in uninvolved mucosa in gastric cancer when compared with controls.…”

Section: Endoscopic and Histologic Examinationmentioning

confidence: 73%

“…The enzyme activities may differ between tumor and uninvolved tissue in patients with cancer and also between uninvolved tissue in such patients and corresponding tissue in control subjects (6,7). Changed membrane enzyme activities have previously been demonstrated in premalignant and malignant tissue and in serum (4,(8)(9)(10). Lysosomal enzymes may be released through injury to the mucosal epithelium, and alteration of lysosomal enzyme activities has been found in benign, premalignant, and malignant gastric mucosa…”

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confidence: 99%

“…The transformation of normal cells into malignant cells may also lead to synthesis of abnormal protein substances (2). Changes in enzymes, isoenzymes, and enzyme variants are found in tissue, blood and body fluid in gastriccancer (3)(4)(5). The enzyme activities may differ between tumor and uninvolved tissue in patients with cancer and also between uninvolved tissue in such patients and corresponding tissue in control subjects (6,7).…”

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confidence: 99%

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Enzyme Activities in Human Gastric Cancer and Polyps

Ødegaard

Børkje

et al. 1986

Scandinavian Journal of Gastroenterology

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Enzyme activities and the protein to DNA ratio in gastric biopsy specimens from patients with gastric cancer and polyps have been measured and compared with values from controls. In uninvolved mucosa in antral gastric cancer increased activities were found for several membrane and lysosomal enzymes, whereas the monoamine oxidase (MAO) activity was decreased (p less than 0.0005). In cancer tissue the MAO was also decreased (p less than 0.0003). In uninvolved mucosa in gastric cancer of the body, most membrane and lysosomal enzyme activities were increased. In the cancer tissue itself an increase in membrane enzyme activities was found for several enzymes, whereas the MAO activity was decreased (p less than 0.0001). Differences between activities in specimens from the gastric mucosa in patients with gastric polyps and those in controls were less pronounced than between gastric cancer and controls. A discriminant analysis, using the enzymes most sensitive to establish correct diagnosis, could identify normal gastric mucosa in 85-95%, atrophic gastritis in 56-63%, and uninvolved mucosa in gastric cancer in 66-78%.

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“…In humans, plasma GGT determinations have also been reported to correlate closely with the clinical status; i.e., significantly elevated GGT levels corresponded to disease progression and death. Patients with low enzyme levels were found to be free from disease [21,22]. In a more recent report, GGT isoenzymes were determined as a potential specific marker for primary or metastatic liver neoplasia [23].…”

Section: Discussionmentioning

confidence: 99%