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)

Assays of immune function (recall skin tests to microbial antigens; total circulating lymphocytes, T-cells, B-cells; lymphocyte blastogenesis with PHA, Con A, and pokeweed mitogens; and serum immunoglobulins IgA, IgM, IgG) were obtained in 408 patients with unresectable gastrointestinal carcinoma. The overall patient population, in comparison to normal controls, was characterized by reduced response to recall skin tests, reduced total lymphocyte and T-cell counts, reduced lymphocyte blastogenesis assays, increased B-cell counts and increased IgA and IgM. Significant immunosuppression was associated with prior radiation or chemotherapy, and with impaired patient performance status. There was no apparent correlation between extent of clinically evident malignant disease and immune function within this patient population. No assay of immune function matched the prognostic value of the more readily available and less expensive determinations of performance status, serum alkaline phosphatase, or SGOT. Only reactivity to recall skin tests had a significant correlation to patient survival independent of performance status. Among patients with little or no disability, only intensity of skin test reactivity correlated significantly with survival; and among those with greater disability, there was correlation only with proportion of skin tests positive. The combination of candida and streptokinase antigens provided the best recall skin test survival correlation. Adding a third, fourth, or fifth antigen did not add to prognostic value. From an overall standpoint, the immune determinants which we studied do not appear to provide useful additions to the evaluation of the patient with unresectable gastrointestinal cancer.
 ...
PMID:Nonspecific immune determinants in the patient with unresectable gastrointestinal carcinoma. 37 93

The diagnostic values of CA 19-9 and CEA were evaluated in 187 cases (including 31 gastric, 41 colorectal, 12 pancreatic, 7 hepatobiliar and 5 hepatocellular carcinomas). These tumor markers were compared to the other laboratory parameters [hemoglobin, erythrocyte sedimentation rate, serum bilirubin, ASAT (aspartate amino transferase), ALAT (alanine amino transferase) GGT (gamma glutamil transpeptidase), ALP (alkaline phosphatase)]. The specificity of CA 19-9 was 89.5%, while the sensitivity of this tumor markers was 91.7% in pancreatic carcinoma, 54.8% in gastric carcinoma and 43.9% in colorectal carcinoma. The sensitivity of CEA only in colorectal patients was higher than that of CA 19-9 (specificity 73.9%, sensitivity 64.5%). Although the CA 19-9 and CEA are not known to give any cross-reaction with each other, simultaneous measurement and evaluation of these two tumor antigens did not result in a better diagnostic sensitivity. After undergoing a gastrointestinal carcinoma operation, CA 19-9 indicated the appearance of tumor recidiva with a 62% sensitivity. Calculated together with CEA the sensitivity elevated to 88.9%. In most of the patient with benign cholostasis, the CA 19-9 and CEA values were out of the normal range (53.3% and 36.4% respectively), so these tumor markers are not suitable to differentiate between benign and malign cholostasis. According to the authors, CA 19-9 is the most useful diagnostic tool to differentiate between pancreatic carcinoma and pancreatitis chronica (both group without cholostasis), as well as for monitoring the patients after surgery of a gastrointestinal cancer.
 ...
PMID:[Diagnostic value of CA 19-9 and CEA in gastrointestinal pathology]. 160 81

The efficiency of composite tests (liver scintigraphy, serum alkaline phosphatase, and serum carcinoembryonic antigen) in finding or excluding liver metastases preoperatively was evaluated in 185 surgical patients with high probability for gastrointestinal cancer--142 with colorectal and 43 with gastric disorders. A pathoanatomic verification procedure showed liver metastases in 21 and 7 patients, respectively. For each test two cut-off levels were defined in accordance with the operational purpose of the test: either to diagnose metastases (no false-positive test results) or to exclude metastases (no false-negative test results). Generally, composite tests increased overall efficiency; in the colorectal group 39% of the patients were correctly classified by the combined, triple test; in the gastric group 94% were correctly classified. In conclusion, we think composite tests are useful, and the operational approach described may be helpful in decision-making and test evaluation.
 ...
PMID:Efficiency of composite tests in gastrointestinal cancer. Preoperative prediction of liver metastases by scintigraphy, alkaline phosphatase, and carcinoembryonic antigen. 329 32

Surgeons' ability to predict liver metastases preoperatively was studied in 185 operable, nonicteric patients strongly suspected to have gastrointestinal cancer. The prediction was based on a clinical assessment comprising medical history, physical examination and low-cost laboratory tests. A pathoanatomic verification procedure was used. The observed predictive value of a positive test was 0.67 and there was a false-negative ratio of 0.79. At the clinical assessment, presence of metastases was believed to be more common in gastric than in colorectal disease (6/43 vs. 3/142), but the actual incidence of metastases was similar in the two groups. Serum alkaline phosphatase (AP) was a priori believed to be of value in the clinical assessment. But the clinical assessment with inclusion of AP was inferior to AP alone as a predictor of metastases, due to undervaluation of the importance of elevated AP in cases of colorectal disease. The difficulties in standardization of the clinical assessment are underlined.
 ...
PMID:The value of clinical assessment for preoperative prediction of liver metastases in suspected gastrointestinal cancer. A prospective, consecutive study. 395 16

The results of biochemical estimations in 116 patients with known gastrointestinal cancer but no clinically detectable metastatic hepatic disease have been analyzed statistically. The most sensitive and the most specific tests for the presence or absence of hepatic metastasis were measurements of alkaline phosphatase and gamma-glutamyl transpeptidase. The predictive value for the absence of hepatic metastasis when the test results were normal was about 90% for alkaline phosphatase, gamma-glutamyl transpeptidase, lactate dehydrogenase, and serum aspartate aminotransferase. The best predictive value for the presence of hepatic metastasis (80%) was given by abnormal results of combined estimations of gamma-glutamyl transpeptidase and lactate dehydrogenase, and of gamma-glutamyl transpeptidase and serum aspartate aminotransferase.
 ...
PMID:Hepatic metastases in gastrointestinal cancer: diagnostic value of biochemical investigations. 611 4

The objective of this study was to investigate the potential benefit of branched chain amino acid (BCAA)-enriched total parenteral nutrition (TPN) for malnourished surgical patients with gastrointestinal cancer. Sixty-four malnourished patients with gastrointestinal cancer with elective surgical intervention were equally allocated into two groups to receive isonitrogenous and isocaloric TPN. All of them must have received TPN soon after surgery and were subsequently randomized and divided into either BCAA-enriched TPN (30% BCAA; intervention group) or standard TPN (24% BCAA; control group). Patient biochemical data, nutritional parameters, and clinical outcome were collected to analyze the significance of BCAA-enriched TPN. After a period of TPN, laboratory data, including white blood cell (WBC), C-reactive protein (CRP), alkaline phosphatase (ALK-P), and gamma-glutamyltransferase (gamma-GT) levels, were significantly different between these two groups (all P < 0.05). Decreasing white blood cell and C-reactive protein levels were observed in the intervention group that might partially explain the reduced numbers of infectious complications. Furthermore, elevating alkaline phosphatase and gamma-glutamyltransferase levels being also less prominent might indicate a lesser hepatic burden by using BCAA-enriched TPN. The BCAA-enriched TPN can maintain a patient's serum visceral protein (albumin and prealbumin) and positive nitrogen balance better than standard TPN (all P < 0.05). Furthermore, a prominently decreased frequency of postoperative morbidity was also found in the BCAA-enriched TPN group (P = 0.021) despite no difference regarding surgical mortality. Our observations show that BCAA-enriched TPN may be beneficial in improving the nutritional status and reducing postoperative complications for malnourished patients with gastrointestinal cancer undergoing major surgery.
 ...
PMID:Randomized, controlled study of branched chain amino acid-enriched total parenteral nutrition in malnourished patients with gastrointestinal cancer undergoing surgery. 1837 91