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

Biological detection of liver metastases represents an important factor in the surveillance of the course of cancerous affections. The authors present a report on a potential new indicator, the isoenzyme of alkaline phosphatase migrating to the alpha 1 region (alpha 1 ALP). In comparison to those tests considered the most sensitive at present-gamma glutamyl transferase and total alkaline phosphatase-this alpha 1 isoenzyme appears more sensitive and more specific, capable of detecting 97% of liver metastases with a specificity of 90%.
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PMID:Comparative study of gamma glutamyl transferase, alkaline phosphatase and its alpha 1 isoenzyme as biological indicators of liver metastases. 611 83

Gamma-glutamyltransferase (gamma-GT) was found to exceed the upper normal limit in 31 of the 32 patients with liver metastases verified during surgery or at autopsy, while the level of this enzyme was normal in 25 of the 28 patients with proven neoplasma but without evidence of metastatic involvement of the liver. Particularly high values of gamma-GT activity were noted in 9 patients in whom liver metastases were accompanied by clinical jaundice. A similar behaviour was noted for alkaline phosphatase but changes affecting this enzyme were less obvious. Thus, for a mean increase of gamma-GT to levels up to seven times the upper normal limit, the level of alkaline phosphatase increased only three times. A decrease of serum pseudocholinesterase occurred in most patients with neoplasma, the process being more evident when liver metastases were present. It is concluded that an increase of gamma-GT in a patient with neoplasma could be considered as a marker of hepatic metastases, if chronic alcoholism or hepatobiliary disease can be excluded.
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PMID:Value of gamma-glutamyltransferase in the diagnosis of liver metastases. 612 70

Liver metastases due to the more common neoplastic diseases such as colorectal, breast, or bronchogenic carcinoma are a frequent occurrence and are associated with an ominous prognosis. Earlier detection followed by appropriate therapeutic interventions might have a decided effect on the subsequent course of disease. Controversy exists over the selection of tests with the greatest sensitivity, specificity, and potential utility. Preliminary evidence suggest that gamma-glutamyl transpeptidase and 5'-nucleotidase may be of particular significance. Four enzymes--gamma-glutamyl transpeptidase, 5'-nucleotidase, leucine aminopeptidase, and alkaline phosphatase plus carcinoembryonic antigen--were compared in the same blood samples from selected patients with breast and small cell carcinoma of the lung. Gamma-Glutamyl transpeptidase was the most sensitive test with 28/29 (97%) patients with hepatic metastases having elevated enzymatic activity in their sera. For patients with small cell carcinoma of the lung followed serially, gamma-glutamyl transpeptidase activity was increased an average of 5 months before liver metastases were detected by clinical means. Two factors are important in the interpretation of the results of gamma-glutamyl transpeptidase analysis: (1) Hepatic dysfunction due to diseases other than metastatic tumor involvement can cause a rise in enzyme levels as can (2) medications or ethanol which activate the hepatic microsomal drug metabolizing system. Of particular importance, however, is the fact that antitumor chemotherapy, even intensive and multiple agent, did not appear to effect the enzyme activity in the sera of patients with breast or small cell carcinoma of the lung. Gamma-glutamyl transpeptidase in combination with carcinoembryonic antigen may be of particular value in detecting liver metastases and in assessing subsequent response to therapy.
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PMID:Biological markers as an aid in the clinical management of patients with liver metastases. 612 62

Measurement of the alpha 1 (fast liver) fraction of alkaline phosphatases in the serum for 217 cancer patients, 92 patients with nonmalignant hepatic affections and 131 controls, revealed that the alpha 1 fraction offers better global value (94%), sensitivity (96%), and specificity (93%) than gamma GT or total alkaline phosphatase determinations for the detection of liver metastases during cancer. Initial data from study of the time of appearance of the alpha 1 fraction reveals that this fraction shows up earlier than rises in the gamma GT or total alkaline phosphatases. Results of a multiparametric study conducted on the alpha 1 fraction and various hepatic enzymatic tests (SGOT, SGPT, GLDH, ALP, gamma GT) indicate that the alpha 1 fraction used alone is better than any other test or combination of tests for biological detection of liver metastases. As concerns the influence of chemotherapy on the appearance of the alpha 1 fraction, the majority of the drugs used for anticancer chemotherapy do not seem to affect measurement of the alpha 1 ALP fraction. The alpha 1 fast liver fraction of alkaline phosphatases, detected by electrophoresis on cellulose acetate, can be considered one of the best known tests for the detection of liver metastases.
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PMID:Alpha 1 isoenzyme of alkaline phosphatases. Clinical importance and value for the detection of liver metastases. 613 10

We describe a simple, rapid, and reproducible ion exchange mini-column chromatographic method for the quantitative measurement of biliary alkaline phosphatase in plasma. We have used this method to evaluate a cellulose acetate electrophoretic method, which was used to assess the value of measuring biliary alkaline phosphatase in 85 patients with breast cancer investigated for possible hepatic metastases. Biliary alkaline phosphatase activity was abnormal in 19 of 24 patients (79%) with liver metastases, but abnormalities were also found in 12 of 61 patients (20%) without hepatic metastases; in only 37% of patients with positive test results was this a consequence of liver metastases. For the identification of liver metastases, therefore, the method has useful sensitivity but limited specificity. Neither sensitivity nor specificity was significantly better than that of plasma gamma-glutamyltransferase activity, which was measured concomitantly.
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PMID:Measurement of biliary alkaline phosphatase by mini-column chromatography and by electrophoresis and its application to the detection of liver metastases in patients with breast cancer. 614 Nov 85

In 133 patients laparotomized for colorectal cancer the serum-5-nucleotidase, alkaline phosphatase and gamma-glutamyltransferase were analysed preoperatively. The presence of liver metastases was established at laparotomy by palpation (prevalence 19%). The serum enzyme levels were elevated in 10-18% of patients without liver metastases and in 48-64% of patients with liver metastases. A comparison of the estimated tumor volume in the liver and the serum enzyme levels was performed. The predictive values of the three tests were computed at different reference limits. It was concluded that none of the tests used had any advantage of the other. To increase the diagnostic yield another reference limit than the normal at the laboratory can be used.
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PMID:Value of serum-5-nucleotidase, alkaline phosphatase and gamma-glutamyl transferase for prediction of liver metastases preoperatively in colorectal cancer. 614 27

By fusion of C3H mouse spleen cells, immunized with a PCA extract from liver metastases of a colon tumor, and Sp2/O-Ag14 myeloma cells, we produced several clones secreting monoclonal antibodies (MAb) with reactivity against carcinoembryonic antigen (CEA). For the screening of the different MAb, an ELISA technique with PCA extract and highly purified CEA coupled with alkaline phosphatase was employed. The specificities of the MAb prescreened with the ELISA technique were analyzed further by immunoprecipitation and separation on SDS-PAGE, followed by enzyme digestion and thin-layer chromatography for fingerprint analysis. The MAb recognized (a) an antigenic determinant present only on CEA, (b) common determinants present on CEA and at least six other molecules separated by SDS-PAGE and (c) antigenic determinants not present on CEA. The fingerprint analysis showed the relationship of the molecules on the basis of protein chemistry.
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PMID:Monoclonal antibodies against CEA. Comparison of the immunoprecipitates by fingerprint analysis. 618 85

Liver metastases are a common cause of death in colon carcinoma. The dual blood supply of the liver permits regional perfusion while hepatic catabolism fo 5-fluorouracil (FU), floxuridine (FUdR) permit higher drug exposures than systemic (IV) administration. We have studied the effect of continuous intra-arterial chemotherapy (FU: 5-10 mg/kg/day and FUdR: 0.2 mg/kg/day) and whole liver irradiation (1000 rad every 4 weeks, total dose of 3000 rad) for metastatic colon carcinoma to liver. Eighteen patients with metastases to liver only are reported using this combination therapy. Seven patients had percutaneous placement of a catheter via the brachial artery, two had operative placement of a catheter via the gastroduodenal artery, all of which were connected to the Cormed infusor system, nine had operative placement of the Infusaid implantable pump with catheter placement into the hepatic artery via the gastroduodenal artery. The median survival for the entire group was 241 days. In those patients whose liver function tests (bilirubin and alkaline phosphatase) were less than two times normal, the median survival was 770 days. The median survival of the patients with greater than two times normal LFT's was 178 days. Two patients died of complications of the treatment. One who developed irreversible radiation hepatitis but at autopsy had only two areas of microscopic tumor foci in the liver and another who had received only 15 days of infusion and 1000 rad to liver. This patient developed irreversible chemical enteritis secondary to chemotherapy infusion into the superior mesenteric artery. Three patients have undergone abdominal reexploration and one at autopsy, who were found to have no gross evidence of tumor in the liver despite previous pathologic confirmation. It appears that some patients with minimal tumor burdens can have sterilization of their tumors. There were three cases of reversible liver function abnormalities. Complications associated with conventional intra-arterial chemotherapy (artery thrombosis, catheter sepsis and dislodgement, pump infusion variation and pump failure) were not seen with the Infusaid delivery system. The pump is refilled every 2-3 weeks via percutaneous puncture. All therapy was given on an outpatient basis. Pump acceptance and tolerance was 100%. Intra-arterial chemotherapy can now be accomplished without the morbidity associated with it in the past. The combination of chemotherapy and liver irradiation may offer improved survival in selected patients.
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PMID:Intra-arterial chemotherapy using an implantable infusion pump and liver irradiation for the treatment of hepatic metastases. 621 14

This is a study of 269 patients with lung cancer at the Erie County Medical Center who were admitted between 1973 and 1978. They were analyzed for sex, race, age, history of smoking, occupation, tumor cell type, cytology, incidence of metastases, changes in liver function, mode of treatment, and survival. The incidence of cancer was highest in white males. Only 1.5% of patients were under age 40. Smoking was a predisposing factor. Not enough information was available to determine the relationship of occupation to lung cancer. Squamous cell carcinoma was the most common (53.9%), followed by adenocarcinoma (16.0%) and small-cell carcinoma (12.6%). Sputum cytology was 28.3% sensitive, and bronchial washings were 52.2% sensitive. A greater incidence of bone metastases from a small-cell primary (50%) was found than is reported in the literature. Changes in SGOT and/or SGPT liver enzymes correlated significantly with liver metastases, but not with tumor cell type. Changes in alkaline phosphatase correlated well with bone metastases. Radiation was the most commonly used mode of therapy. The best survival was achieved in patients treated by surgery (22.6 months), followed by surgery and radiation (16.2 months); those treated by radiation alone had a mean survival time of 8.7 months. Untreated patients had a mean survival time of 2.4 months. Treated patients with adenocarcinomas had the longest survival (18.5 months), compared to 13.0 months for those with squamous cell carcinomas and 8.4 months for those with small-cell carcinomas. Only three patients survived 5 years, all of whom were treated surgically for adenocarcinoma. No patients with tumors of other cell types survived 5 years. The 5-year survival rates are 2.1% (3 of 141) for all histologic types of lung cancer and 12.5% (3 of 24) for adenocarcinoma.
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PMID:Epidemiologic and prognostic factors for lung cancer in a county hospital. 627 16

A prospective comparative study between liver enzymes, scintigraphy, ultrasonography and computed tomography for detection of liver metastases was performed in 113 patients who were eligible for operation for a carcinoma in the gastrointestinal tract. Twenty-three of the 113 patients (20 per cent) had liver metastases. The accuracy of scintigraphy was 79 per cent, of ultrasonography 85 per cent and of computed tomography 88 per cent. The results of these tests showed no statistical differences. Ultrasonography and computed tomography were significantly more accurate than alkaline phosphatase and gamma-glutamyl transpeptidase (respectively P less than 0.01 and P less than 0.05). Taking into account cost effectiveness, simplicity and patient tolerance, ultrasonography is the test of choice for the detection of liver metastases.
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PMID:Detection of liver metastases. A prospective study comparing liver enzymes, scintigraphy, ultrasonography and computed tomography. 638 26


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