Clinical significance of appearance of serum γ-glutamyl transpeptidase isozyme

Abstract

Serum gamma-glutamyl transpeptidase zymograms were examined by 4--26% polyacrylamide gradient gel slab electrophoresis using sera from 90 patients with various hepatobiliary diseases. The isozyme bands were separated into 13 bands in order from post albumin fraction. Characteristic patterns of the zymograms were obtained in cases of hepatocellular carcinoma and cholestasis. Bands I, II and II' may be specifically related to hepatocellular carcinoma. Band I was observed frequently in hepatocellular carcinoma, however it was also occasionally observed in alcoholic liver injury and metastatic liver cancer. Both band II and II' were only observed in hepatocellular carcinoma cases. The origin of band II and/or II' was not clarified but band I might appear through some proteolytic process in hepatoma tissue and also liver affected by alcohol. In cholestatic cases the activity of bands III and IX were prominent. The frequency of band VI decreased according to the severity of jaundice and a negative correlation appeared to exist between bands III and VI. This phenomenon may be partially related to lipid metabolism disorder which is frequently observed in cholestasis. Results of analysis of the frequency of appearance of these bands did not permit differentiation between intra- and extrahepatic cholestasis.

The diagnostic value of a hepatoma‐specific band of serum gamma‐glutamyl transferase

“…It is thus necessary to search for new markers of hepatoma in addition to AFP determination. Some investigators, using polyacrylamide gel gradient electrophoresis, have fractionated 1-3 bands of GGT specific for hepatoma with a positivity rate of only 27-63% (Sawabu et al, 1977(Sawabu et al, , 1983Kojima et al, 1980;Suzuki, 1981). In our laboratory, adopting the method of vertical slab stage electrophoresis on polyacrylamide gel, we have been able to fractionate a total of 9-11 activity bands of GGT, in which GGT I T is found in sera from almost all patients with hepatoma.…”

“…, 1977(Sawabu et a/. , , 1983Kojima et al, 1980;Suzuki, 1981) with evidence of diagnostic value in hepatobiliary pathology, particularly hepatoma. We have been able to separate a GGT-11 band with stage electrophoresis on polyacrylamide gel (Xu et al, 1983), but the percentage of positive results in hepatoma was too low (29.1 %) to permit clinical application.…”

Diagnostic value of protein induced by vitamin K absence (PIVKAII) and hepatoma-specific band of serum gamma-glutamyl transferase (GGTII) as hepatocellular carcinoma markers complementary to α-fetoprotein

“…Since then, other methods have been used, that is, separation of GGT bands by means of starch gel (Orlowski and Szczeklik, 1967), cellulose acetate (Hitoi et al, 1984), agarose gel (Hetland et al, 1975), polyacrylamide gel electrophoresis (Kojima et al, 1980;Suzuki et al, 1981;Sawabu et al, 1983;Kew et al, 1984), and polyacrylamide stage gel plate (Xu et al, 1985). The polyacrylamide stage gel plate method allows detecting positivity up to 90% in hepatoma patients (Xu et al, 1985).…”

Evaluation of the albumin‐γ‐glutamyltransferase isoenzyme as a diagnostic marker of hepatocellular carcinoma‐complicating liver cirrhosis

“…22 In recent years, Asian researchers documented the presence of up to 11 serum GGT isoenzymes, and showed that the faster isoforms (bands I-II) are often present in the serum of HCC patients. [23][24][25][26][27] In the 1980s, an Italian group developed an electrophoretic procedure for the analysis of GGT isoenzymes. Of the five different isoenzymatic bands that could be distinguished, the one that comigrates with serum albumin (alb-GGT) appeared to be promising for the diagnosis of both primary and secondary liver tumors.…”

“…The complexes occur in the serum as a consequence of the GGT overexpression from neoplastic liver cells and of the biliary impairment typical of the neoplastic liver, and they produce the GGTL isoform that has been found to have a sensitivity of 80% and a diagnostic accuracy of 92% at a cut‐off value of 20 U/L 22 . In recent years, Asian researchers documented the presence of up to 11 serum GGT isoenzymes, and showed that the faster isoforms (bands I–II) are often present in the serum of HCC patients 23–27 . In the 1980s, an Italian group developed an electrophoretic procedure for the analysis of GGT isoenzymes.…”