The Role of CEA and Liver Function Tests in the Detection of Hepatic Metastases From Colo-Rectal Cancer

Carcinoembryonic antigen and some liver function tests (alkaline phosphatase, gamma-glutamyl-transpeptidase, lactic dehydrogenase and cholinesterase) were evaluated in patients with primary colorectal cancer in order to define their role in the pre-operative detection of liver metastases.The records of 278 consecutive patients admitted to the Istituto Nazionale Tumori of Milan between January 1982 and December 1983 who were suffering from primary invasive colo-rectal cancer and who underwent laparotomy were retrospectively analyzed.At laparotomy, liver metastases were found in 38 pts (13.7%). Considering single tests, CEA was the most sensitive (71%); no single test was found to be reliably predictive, when the result was abnormal. On the contrary, the normal value of each test was associated with a good prediction.When we considered all the five tests together in the single patient their predictive value, when abnormal, proved to be quite good only if four or five results were abnormal. On the other hand, liver metastases in the presence of all normal tests were found only in two patients, so giving a negative predictive value of about 97%.So we conclude that, in the lack of an infallable imaging technique for liver evaluation, in the presence of all normal tests any other investigation on the liver could be avoided. However, when liver tests are pathologic, some other imaging technique should be performed in order to supply the surgeon with information about the extent and the spread of the metastases.

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Escalating doses of hepatic arterial oxaliplatin in combination with docetaxel and capecitabine in patients with liver metastases from non-colorectal gastrointestinal malignancies

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14110 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14110-14110

Author(s):

S. De La Cruz ◽

J. Rodriguez ◽

J. De La Cámara ◽

G. Nagore ◽

S. Viteri ◽

...

Keyword(s):

Liver Function ◽

Liver Metastases ◽

Dose Level ◽

Hepatic Metastases ◽

Liver Function Tests ◽

Gastrointestinal Malignancies ◽

Function Tests ◽

Level 3 ◽

Level 1 ◽

Grade 3

14110 Background: Docetaxel (T), oxaliplatin (O) and capecitabine (C) are active agents in gastrointestinal (g.i.) tumors. Synergism has been reported in several preclinical studies. The purpose of this study was to assess the maximum tolerated dose of hepatic arterial oxaliplatin in combination with docetaxel and capecitabine in patients (pts) with hepatic metastases from non-colorectal g.i. tumors. Preliminary evidence of activity was also evaluated. Methods: Patients with liver metastases from gastric (n=3), pancreas (n=6), esophageal (n=2) and cholangiocarcinoma (n=1) were treated with fixed doses of docetaxel (60 mg/m2), capecitabine (650 mg/m2 bid on days 1–14) and escalating doses of hepatic intraarterial oxaliplatin. Oxaliplatin dose was escalated according to the following schedule: level 1, 100 mg/m2; level 2, 110 mg/m2; level 3, 120 mg/m2. The cycle was repeated every 3 weeks. A CT scan or MRI was performed to evaluate response. Liver function tests were performed the day after and before the hepatic arterial infusion. Results: The median number of cycles was 5. At first dose level, 1 pt showed grade 3 mucositis and capecitabine intolerance that required treatment discontinuation. Three pts were later included in the same level with no further toxicity. At dose level 3, grade 3 vomiting was recorded in 1 pt and subsequently this level is now being expanded. Liver function tests on day 2 were elevated over baseline in 10 pts (83%). Seven pts (58%) required morphine due to pain associated with intraarterial infusion. Among 11 evaluable pts, 10 (83%) PRs have been confirmed. Conclusions: Accrual is ongoing at dose level 3. Preliminary data on efficacy seems promising. No significant financial relationships to disclose.

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Diagnosis and significance of liver metastases in small cell carcinoma of the lung.

Journal of Clinical Oncology ◽

10.1200/jco.1984.2.7.733 ◽

1984 ◽

Vol 2 (7) ◽

pp. 733-741 ◽

Cited By ~ 16

Author(s):

J L Mulshine ◽

R W Makuch ◽

A Johnston-Early ◽

M J Matthews ◽

D N Carney ◽

...

Keyword(s):

Liver Function ◽

Liver Biopsy ◽

Liver Metastases ◽

Hepatic Metastases ◽

Liver Function Tests ◽

Small Cell ◽

Function Tests ◽

Liver Scan ◽

Prognostic Implications ◽

Correct Discrimination

One hundred fifty-seven consecutive patients with small cell lung cancer seen at the National Cancer Institute over a four-year period underwent a series of pretherapy liver staging procedures to determine optimal means of detection and prognostic implications of hepatic metastases. Liver evaluation included physical examination, liver function tests, and liver scan (radionuclide or computerized tomography [CT]), as well as percutaneous and/or peritoneoscopy-directed liver biopsy when possible (74%). Liver metastases were detected in 26% of patients. Peritoneoscopy was the most sensitive method of liver evaluation and increased the detection of liver metastases when done in a sequential fashion after percutaneous liver biopsy from 18 to a total of 27 patients. Of the noninvasive procedures, radionuclide and CT liver scan were the most accurate concurring with liver biopsy in 87% of patients but permitting correct discrimination of stage in excess of 96% of patients. The accuracy of this noninvasive procedure was enhanced by an algorithm combining the results of radionuclide liver scan with liver function tests to detect patients with high or low likelihood of liver involvement. The survival and response of patients with liver metastases was significantly worse than those without such metastases with no three-year disease-free survivors among patients with liver metastases.

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New insights into vitamin D regulation: is there a role for alkaline phosphatase?

Journal of Endocrinological Investigation ◽

10.1007/s40618-021-01503-w ◽

2021 ◽

Author(s):

G. Bellastella ◽

L. Scappaticcio ◽

M. Longo ◽

R. Carotenuto ◽

C. Carbone ◽

...

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Liver Function ◽

Significant Negative Correlation ◽

Liver Function Tests ◽

Bone Alkaline Phosphatase ◽

Gamma Glutamyl Transpeptidase ◽

Function Tests ◽

Group 2 ◽

Group 1

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r = − 0.03; p = 0.8), ALT (r = − 0.02; p = 0.91), GGT (r = − 0.08; p = 0.68), direct bilirubin (r = − 0.02; p = 0.89), indirect bilirubin (r = − 0.24; p = 0.21), and total bilirubin (r = − 0.24; p = 0.21) but one between 25OHD and ALP (r = − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r = − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

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ABNORMALITIES OF LIVER FUNCTION AND THE PREDICTIVE VALUE OF LIVER FUNCTION TESTS IN INFECTION AND OUTCOME OF ACUTELY ILL ELDERLY PATIENTS

Age and Ageing ◽

10.1093/ageing/13.4.224 ◽

1984 ◽

Vol 13 (4) ◽

pp. 224-229 ◽

Cited By ~ 4

Author(s):

ROSE ANNE M. KENNY ◽

H. M. HODKINSON ◽

OONAGH F. PRENDIVILLE ◽

MARY C. HAYES ◽

M. D. FLYNN

Keyword(s):

Liver Function ◽

Elderly Patients ◽

Predictive Value ◽

Liver Function Tests ◽

Function Tests

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Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

Internal and Emergency Medicine ◽

10.1007/s11739-020-02425-w ◽

2020 ◽

Vol 15 (8) ◽

pp. 1399-1407 ◽

Cited By ~ 3

Author(s):

Marco Vincenzo Lenti ◽

◽

Federica Borrelli de Andreis ◽

Ivan Pellegrino ◽

Catherine Klersy ◽

...

Keyword(s):

Internal Medicine ◽

Intensive Care ◽

Liver Function ◽

Laboratory Data ◽

Liver Function Tests ◽

Gamma Glutamyl Transpeptidase ◽

Function Tests ◽

Altered Liver ◽

The Impact ◽

Internal Medicine Unit

Abstract Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

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