Combined analysis of serum γ-glutamyl transferase isoenzyme II, α-L-fucosidase and α-fetoprotein detected using a commercial kit in the diagnosis of hepatocellular carcinoma

Abstract

γ-glutamyl transferase isoenzyme II (GGT-II) is a sensitive biomarker of hepatocellular carcinoma (HCC). However, numerous disadvantages of the traditional manual method affected its application. The commercial kit provided a convenient and fast method for the determination of GGT-II levels. The purposes of the present study were to compare the reproducibility and sensitivity between the manual and commercial kit methods and to evaluate the diagnostic efficiency for HCC with the combined analysis of GGT-II, α-L-fucosidase (AFU) and α-fetoprotein (AFP). In patients with various liver diseases (HCC, liver cirrhosis and chronic hepatitis) and normal subjects, GGT-II was detected by manual and commercial polyacrylamide gel electrophoresis (PAGE). The levels of AFU and AFP were assayed by colorimetry and a chemiluminescence immunoassay, respectively. The commercial PAGE had equal diagnostic efficiency with traditional manual PAGE and no significant differences were observed in intra- and average-gel reproducibility and GGT-II sensitivities between the manual and commercial PAGE (P>0.05). The incidence of GGT-II detected by commercial PAGE in HCC patients was 84.1% and <8% in benign liver disease. The levels of AFU and AFP in the benign liver diseases and normal subjects were lower than those in HCC. According to the cut-off value obtained by receiver operating characteristic curves, a total of 56.6 and 59.3% of HCC patients (64 out of 113 and 67 out of 113) had AFU >636.5 μmol/l h and AFP >44.0 μg/l, respectively. There were no significant correlations between GGT-II and AFU or AFP. Combined detection of GGT-II with AFU or AFP increased the diagnostic sensitivity to 92.9 and 93.8%, respectively. These results suggest that commercial PAGE provides a simple and reproducible method for GGT-II detection. Combined determination of GGT-II with AFU or AFP exhibited superior sensitivity and specificity for the diagnosis of HCC.

Evaluation of the diagnostic value of alpha‐l‐fucosidase, alpha‐fetoprotein and thymidine kinase 1 with ROC and logistic regression for hepatocellular carcinoma

“…Moreover, false‐negative or false–positive results can often be detected for some reason – including geographical and ethnic variations and different techniques being performed[7]. For these reason, it is necessary to perform a conjoint combination of various of biomarkers in the diagnosis of HCC[7].…”

Serum GP73 is complementary to AFP and GGT-II for the diagnosis of hepatocellular carcinoma

“…Serum GGT-II was determined using polyacrylamide gel electrophoresis kits (Jiangsu Zongheng Co., Ltd., Nantong, China), as described previously (16). …”

Role of biomarkers in the prediction and diagnosis of hepatocellular carcinoma

“…GGTⅡ is a hepatoma-specific GGT and an early enzyme marker of precancerous and cancerous processes [43] . At threshold levels of 100 U/L and 100 IU/mL for GGT and AFP, respectively, GGT had a higher sensitivity and a lower specificity than AFP (69.5% vs 43.5%) and (41.9% vs 96.4%), respectively, for the diagnosis of HCC.…”