alpha-chymotrypsin and Liver-Cirrhosis

In spite of having been the object of a number of studies, the association of morphologic and functional alterations of the pancreas with liver cirrhosis is as yet controversial. Therefore, the authors have studied exocrine pancreatic function in 40 patients: 8 with alcoholic cirrhosis, 18 with non-alcoholic cirrhosis, and 14 without evidence of hepatobiliary and pancreatic pathology. Pancreatic function was studied by the fecal chymotrypsin test which is sufficiently sensitive and specific and has been preferred in view of its practicability and non-invasiveness. Analysis of the results showed pathologic values to be significantly more frequent in subjects with alcoholic cirrhosis (50%, p < 0.05) compared to non-alcoholic cirrhotics (11.11%) and to controls (7.2%). These findings go to show that pancreatic exocrine deficit is frequently associated with alcoholic cirrhosis, thus confirming what has already been known about the pathogenetic role of alcohol which is apt to provoke both hepatic and pancreatic damage. Finally, it should be pointed out that pancreatic exocrine deficit is a purely functional alteration without clinical manifestations.

Topics: Aged; Chymotrypsin; Exocrine Pancreatic Insufficiency; Feces; Female; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pancreatic Diseases; Pancreatic Function Tests

Alpha-1-antitrypsin (A1AT) has been shown to be a useful tumor marker for hepatocellular carcinoma (HCC) and some other neoplasms. No studies of alpha-1-antichymotrypsin (A1AChy) in HCC have been reported. A comparative study of A1AT and A1AChy in HCC was undertaken. While 19/33 HCC were positive for A1AT, all 33 HCC contained immunoreactive A1AChy. Cells showing positive immunoreaction for both A1AT and A1AChy were more numerous in moderately differentiated HCC than in well differentiated or poorly differentiated HCC. Although the pattern of staining with both antisera was similar, in cases showing positive staining for both antisera, A1AChy-positive cells were more numerous than A1AT-positive cells. The results suggest a useful role for A1AChy as a marker of HCC.

Topics: alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Carcinoma, Hepatocellular; Cell Transformation, Neoplastic; Chymotrypsin; Histocytochemistry; Humans; Hyperplasia; Immunoenzyme Techniques; Liver; Liver Cirrhosis; Liver Neoplasms

The serum levels of alpha-1-antichymotrypsin (ACT) were studied in 168 patients with various liver diseases and cancers in conjunction with other liver function tests, serum sialic acid, AFP and CEA. The ACT levels in acute viral hepatitis and chronic hepatitis were not significantly altered compared with the normal level (220 +/- 40 microgram/ml), although the level was slightly increased or decreased temporarily during the acute phase of the former. In liver cirrhosis, the mean level was significantly lower than the normal in spite of the absence of signs of hepatic decompensation (168 +/- 51 microgram/ml, p less than 0.001). In contrast to cirrhosis, the levels were increased to various extents in 65% of cases with hepatoma, in spite of the association of liver cirrhosis in the majority of them. Much higher levels were observed in all cases of metastatic liver cancers and cancers of the pancreas and the biliary tract. The elevations were observed even in cases without the increase of AFP or CEA. Both in cirrhosis and cancers, ACT levels were not correlated with any of serum bilirubin and serum enzyme activities, but were positively correlated with the levels of plasma fibrinogen and serum sialic acid. The measurement of serum ACT level can be taken advantage of for the diagnosis and monitoring of liver cirrhosis and liver cancers, particularly of hepatoma without AFP elevation.

Topics: alpha 1-Antichymotrypsin; alpha-Fetoproteins; Blood Sedimentation; Carcinoembryonic Antigen; Carcinoma, Hepatocellular; Chymotrypsin; Fibrinogen; Humans; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Sialic Acids

Topics: Adult; Amylases; Carboxypeptidases; Chronic Disease; Chymotrypsin; Clinical Enzyme Tests; Deoxyribonucleases; Humans; Lipase; Liver Cirrhosis; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Ribonucleases; Trypsin

Topics: Anemia, Hemolytic; Cholestasis; Chymotrypsin; Humans; Jaundice; Liver Cirrhosis; Protease Inhibitors; Trypsin Inhibitors

Topics: Aged; Alcoholism; Biopsy, Needle; Cholecystokinin; Chymotrypsin; Drainage; Duodenum; Eating; Fatty Liver; Feces; Female; Humans; Lipid Metabolism; Lipids; Liver; Liver Cirrhosis; Malabsorption Syndromes; Male; Middle Aged; Pancreas; Pancreatic Diseases; Secretin

Topics: Aged; Alcoholism; Bicarbonates; Cholecystokinin; Chymotrypsin; Female; Humans; Liver Cirrhosis; Malabsorption Syndromes; Male; Middle Aged; Pancreas; Secretin

Topics: Antifibrinolytic Agents; Blood Platelets; Cholestasis; Chymotrypsin; Fatty Liver; Fibrinolysin; Hepatitis; Humans; Hypersplenism; Liver Cirrhosis; Liver Cirrhosis, Biliary; Liver Diseases; Trypsin Inhibitors

Trypsin and chymotrypsin concentrations were determined in 180 spot stool specimens from 110 control patients in hospital. The lower limit of normality for each enzyme was placed at the 5% level: 95% of this population excreted feces containing more than 100 mug. of chymotrypsin and 30 mug. of trypsin per g. of feces. Chymotrypsin concentrations appeared to be a more reliable guide to pancreatic function than trypsin concentrations.Fecal chymotrypsin concentrations were subnormal in five patients with chronic pancreatitis, borderline in one patient with relapsing pancreatitis, subnormal in one patient after pancreatectomy, and subnormal in five of nine with carcinoma of the pancreas. Subnormal concentrations of fecal chymotrypsin were found in seven of 21 patients with chronic liver disease related to alcoholism, eight of 32 with a partial gastrectomy, three of 10 with adult celiac disease and five of 16 with psoriasis.It appears that the determination of fecal chymotrypsin concentrations provides a valuable screening test for pancreatic exocrine deficiency. However, normal results may be found in some patients with pancreatic disease and subnormal values may occur in some patients with other conditions.

Topics: Alcoholism; Chymotrypsin; Feces; Humans; Liver Cirrhosis; Malabsorption Syndromes; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatitis; Skin Diseases; Trypsin

Topics: Adult; Aged; Breast Neoplasms; Carcinoma; Cholecystitis; Chymotrypsin; Colorimetry; Duodenal Ulcer; Female; Hepatitis; Humans; Intestinal Diseases; Liver Cirrhosis; Lung Diseases; Lung Diseases, Obstructive; Male; Middle Aged; Neoplasm Metastasis; Pancreatitis; Pregnancy; Respiratory Tract Infections; Trypsin Inhibitors

Topics: Ascitic Fluid; Chymotrypsin; Heart Failure; Humans; Liver Cirrhosis; Neoplasms; Pancreatitis; Pleural Effusion; Protease Inhibitors; Trypsin Inhibitors

Topics: Antibodies; Antigen-Antibody Reactions; Ascitic Fluid; Chromatography, Gel; Chymotrypsin; Humans; Liver Cirrhosis; Macroglobulins; Pancreatitis; Pleural Effusion; Protein Binding; Trypsin Inhibitors

Topics: Cardiovascular Diseases; Cholestasis; Chymotrypsin; Diabetes Mellitus; Gastritis; Humans; Liver Cirrhosis; Liver Neoplasms; Lung Diseases; Pancreatic Neoplasms; Pancreatitis; Trypsin Inhibitors

Topics: Amylases; Bicarbonates; Bilirubin; Carboxypeptidases; Cholecystokinin; Chymotrypsin; Humans; Lipase; Liver Cirrhosis; Male; Pancreas; Pancreatic Juice; Phospholipases; Secretin; Secretory Rate; Trypsin