Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and twenty-six patients earlier operated on for colorectal cancer were followed-up once yearly with serum screening tests. The activities of alkaline phosphatase (AP) and gammaglutamyltranspeptidase (GT) were recorded. 58 patients had positive tests. The majority of the patients with liver metastases (20/21) was possible to encircle with these simple serum tests. 38 of the 58 "screening positive patients" were further investigated with celiac angiography and/or liver scintigraphy and liver metastases were very suspect in 29 of these patients. 18 of them were laparotomized and the suspicion was verified in 8.7 of these patients could be subjected to surgery against their liver tumours and 2 of them have then survived more than 2 years. The authors suggest a follow-up system with shorter interval between the examinations.
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PMID:Liver metastases found by follow-up of patients operated on for colorectal cancer. 0 18

We assessed, in 98 patients with cancer, the diagnostic value of measuring serum alkaline phosphatase, 5'-nucleotidase, gamma-glutamyltransferase, and glutamate dehydrogenase activities as an aid to detection of liver metastases. All four enzymes showed diagnostic value, but 5'-nucleotidase appeared to have the greatest. It showed the lowest false-positive results (7.4%) with the highest predictive value of a positive test (85.7%) and agreement (81.3%).. gamma-Glutamyltransferase showed the lowest proportion of false-negative results (2.8%), but was the least specific 35% false-positive results). Analysis of various test combinations showed that the best agreement (77.5%) was obtained when the patients were divided into those who had no or only one abnormal test result, and those who had two or more abnormal test results. However, this was not better than the agreement for 5' nucleotidase alone (81.3%). The agreement of 5'-nucleotidase and gamma-glutamyltransferase (i.e., both tests were positive or negative) was excellent (91.4%), but such agreement included only 67% of the patients with liver metastases.
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PMID:Value of alkaline phosphatase, 5'-nucleotidase, gamma-glutamyltransferase, and glutamate dehydrogenase activity measurements (single and combined) in serum in diagnosis of metastasis to the liver. 2 Oct 41

A study of the value of serum enzymes in 184 patients with colorectal cancer has been performed. The enzymes studied were gamma glutamyltransferase (gammaGT), alkaline phosphatase (AP), lactate dehydrogenase (LDH), 5'-nucleotidase (5'-NT), glutathione reductase (GR), alanine and aspartate transaminases. In patients without liver metastases, elevated enzyme levels were found in 11-55% preoperatively. 5'-NT showed the least number of elevated activities, while gammaGT activities were increased in 29% and LDH in 55%. The percentage of elevated enzyme levels rose significantly in the early postoperative period. Patients with liver metastases showed increased enzyme activities in 40-60% preoperatively: gammaGT was the most sensitive indicator. Increased enzyme activity was related to the degree of liver involvement with secondary tumor. With extensive liver metastases, gammaGT levels were increased in 82%. It is concluded that serum enzymes are of limited value in the preoperative detection of liver metastases, and particularly when tumor involvement of the liver is small.
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PMID:Serum enzymes in colorectal cancer. 3 19

Carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and carcinoplacental alkaline phosphatase (CPALP) were detected simultaneously in the sera and body fluids of two male patients with gastric carcinoma matestatic to the liver. At autopsy, widely disseminated gastric cancer of Borrmann III type with liver metastases was revealed in both bases. Histologically, they were moderately differentiated tubular and papillary adenocarcinomas with marked cellular atypia and necrosis. In Case 1, the properties of CPALP were identical to Nagao type CPALP, and in Case 2 the Variant type CPALP. Using immunofluorescence, CEA and CPALP were demonstrated in both primary and metastatic cells. However, only in Case 2 was AFP observed in some of the primary tumor cells.
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PMID:Carcinoembryonic antigen, alpha-fetoprotein and carcinoplacental alkaline phosphatase in gastric carcinoma metastatic to the liver. 7 44

Two cases of liver metastases from gastric carcinoma are described in which the simultaneous occurrences of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and carcinoplacental alkaline phosphatase (CPALP) were demonstrated in the sera and tumor tissues. AFP was detected not only in the tumor tissues but also in the liver tissue adjacent to the tumor, while the other 2 carcinoembryonic proteins were not detected in the non cancerous liver tissues. The characteristics of CPALP in Case 1 were almost similar to the Nagao isoenzyme, based on enzyme tests involving L-leucine, L-phenylalanine and EDTA inhibitions, heat-stability and Michaelis constant, except for electrophoretical slower moving, while that in Case 2 were identical to variant type CPALP (Warnock).
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PMID:Carcinoembryonic proteins in gastric carcinoma metastatic to the liver. 9 60

In 90 patients with known extra-hepatic malignancy the liver was examined for metastases. The diagnostic value of clinical information, blood examinations, 99mTc scintiscan, and laparoscopy for the diagnosis of the liver metastases was evaluated. Clinical data (age, sex, time since onset of symptoms and localisation of primary tumor) are of no diagnostic value. The most reliable blood tests are alkaline phosphatase (AP) and GOT. The probability of liver metastastases rises with increasingly abnormal values of AP and GOT. However, the probability is not much greater in cases with highly abnormal values than in cases with only moderate elevation of AP and GOT. Diagnostic accuracy of AP is optimal by using a cutoff point of 76 U/l (sensitivity 79%, specificity 64%). Bilirubin, prothrombin time, haemoglobin and blood sedimentation rate are of very little value. Combinations of AP with these blood tests does not improve diagnostic accuracy. Therefore, it is not useful to determine more blood tests than AP alone. Informed reading of liver scans has a specificity of 75% and a sensitivity of 91%. Blind reading of scans has a sensitivity of 94% and a specificity of 95%. This diagnostic accuracy cannot be improved by additional blood tests. Laparscopy has a sensitivity of 85% and a specificity of 95%. Scanning and laparoscopy are complementary methods. When optimal diagnostic accuracy is required both methods should be used.
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PMID:[Liver metastases: diagnostic value of blood tests, scintiscanning, and laparoscopy (author's transl)]. 13 43

Peritoneoscopy with liver biopsy was routinely done as a pretreatment staging procedure in 190 patients with small-cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 28.3% with fusiform cell type (WHO II,1), 28.9% with polygonal cell type (WHO II,2), 41.5% with lymphocytelike cell type (WHO II,3) and 1.3% with mixed types (WHO II, 4). Liver metastases were found in 21% of the patients with adequate liver biopsy. In addition macroscopic signs of liver metastases were observed in 9%. No significant differences were observed among the histological subtypes. Liver function tests, such as alkaline phosphatase, LDH and GOT, were of little value in excluding liver metastases. On the other hand, 2 of 3 abnormal liver function tests were highly indicative of liver metastases. In patients with positive liver biopsy, 41% had liver metastases alone and 76% had no other evidence of distant metastatic disease if bone-marrow involvement identified with bone marrow examination is excluded as a staging procedure.
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PMID:Peritoneoscopy in the staging of 190 patients with small-cell anaplastic carcinoma of the lung with special reference to subtyping. 20 45

Isoenzyme V of 5'-nucleotide phosphodiesterase (5'-NPD-V) is present in the peripheral sera of patients with hepatic metastases. A total of 122 patients underwent prospective serologic analysis followed by operation for primary tumors of the gastrointestinal tract and careful evaluation of the liver. A positive 5'-NPD-V assay was found in fifty-nine of sixty patients with liver metastases. A negative 5'-NPD-V assay was found in forty-three of sixty-two patients with no evidence of hepatic metastases. The accuracy of the test was 84 per cent, and the predictive value was 75 per cent. Serum 5'-NPD-V was abnormal significantly more frequently in patients with metastatic liver disease than were liver scans or carcinoembryonic antigen (CEA), alpha fetoprotein, serum glutamic oxalacetic transaminase (SGOT), and total serum bilirubin or serum alkaline phosphatase levels.
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PMID:Serum 5'-nucleotide phosphodiesterase as a predictor of hepatic metastases in gastrointestinal cancer. 21 45

The clinical assessment of patients with Stages I and II breast cancer is outlined in Figure 1. A chest x-ray film and serum alkaline phosphatase are the only routine studies indicated. If the serum alkaline phosphatase is abnormal in the presence of otherwise normal liver function studies, a bone scan, liver scan, and CEA should be obtained. Areas of increased radioactivity on bone scan are always evaluated by additional radiographs and in some cases tomograms. The majority of focal areas of increased radioactivity will demonstrate radiographic evidence of benign bone lesions, predominantly degenerative joint disease. Only those focal areas of increased radioactivity that are normal on x-ray film or show radiographic evidence of metastases are considered to be positive for metastatic disease. The results of the liver scan are correlated with the level of CEA. Focal areas of decreased radioactivity associated with a CEA greater than 5 ng per ml are considered to be metastases. In the absence of elevation of the CEA, focal areas of increased radioactivity should be biopsied prior to any further considerations as to definitive therapy. The clinical assessment of patients with Stage III disease is outlined in Figure 2. Patients with this stage of disease have a much greater chance of having clinically occult metastases of sufficient size to be detected by chest x-ray film, serum alkaline phosphatase, and bone scan. If the serum alkaline phosphatase is abnormal, a liver scan and CEA are obtained in an effort to detect liver metastases. The same sequence of events is then followed as suggested for patients with Stages I and II disease. Several new techniques of detecting occult metastases are being evaluated. Biomarkers are the subject of another article in this volume. The use of computerized axial tomography is also being evaluated as a means of detecting lung, liver, and mediastinal metastases. The results of these initial clinical trials should be carefully followed.
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PMID:Preoperative assessment of the patient with breast cancer. 35 93

High molecular weight alkaline phosphatase activities have been measured in the sera of 72 patients with a variety of forms of liver disease, 14 patients with bone disease and 8 healthy volunteers. These measurements have been compared with measurements of other indices of hepatic function in order to establish the place of this enzyme in the diagnosis of liver disease. High molecular weight alkaline phosphatase proved to be a sensitive and specific tests for detecting liver disease, particularly obstructive liver disease. It was better than all the other liver function tests in distinguishing liver metastases from other hepatobiliary diseases. It may therefore prove especially useful in the early detection of liver metastases.
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PMID:High molecular weight alkaline phosphatase: a clinical study. 38 97


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