• diagnosis;
  • γ-glutamyltransferase;
  • hepatocellular carcinoma;
  • isoenzymes;
  • liver cirrhosis


Aim: The present study aimed to evaluate the usefulness of albumin-γ-glutamyltransferase isoenzyme in the diagnosis of hepatocellular carcinoma.

Methods: Electrophoretic assays of γ-glutamyltransferase isoenzymes were performed on sera from 190 cirrhotics with (n = 131) or without (n = 59) hepatocellular carcinoma, 36 patients with chronic active hepatitis, 17 patients with liver metastases, and 16 control subjects. In the group of cirrhotic patients, the serum level of α-fetoprotein was also assessed.

Results: Albumin-γ-glutamyltransferase was found in 88 of 131 cirrhotics with hepatocellullar carcinoma, 14 of 59 cirrhotics without hepatocellular carcinoma, nine of 17 patients with liver metastases, and in none of the chronic active hepatitis or control patients. Within the cirrhotic subgroup, albumin-γ-glutamyltransferase was effective in detecting hepatocellular carcinoma in general (sensitivity: 67%; specificity: 76%; diagnostic accuracy: 70%), and small hepatocellular carcinoma (< 3 cm; corresponding figures: 58, 76, and 69%). The best α-fetoprotein value discriminating between hepatocellular carcinoma and non-hepatocellular carcinoma cirrhotics was 20 ng/mL (sensitivity: 54%; specificity 85%; accuracy: 64%). The combined use of albumin-γ-glutamyltransferase and α-fetoprotein, > 20 ng/mL, was associated with greater sensitivity and accuracy (84 and 74%, respectively) than those observed with either of the two markers considered alone.

Conclusions: Albumin-γ-glutamyltransferase appears to be a sensitive diagnostic marker of both advanced and small hepatocellular carcinoma-complicating liver cirrhosis.