A Study on Serum 5' -Nucleotidase Activity in Cases of Liver, Gallbladder and Bone Diseases

Abstract

Determinations were made with Campbell's method of serum 5 '-nucleotidase (5'-N) activity in 116 cases of liver, gallbladder diseases, gastrc cancer and bone diseases. At the same time activities were studies of transaminase (TA), isocitric dehydrogenase (ICD), alkaline phosphatase (ALP), leucine aminopeptidase (LAP) and β-glucuronidase (β-G). Also, S. D. strain rats subjected to acute CCl₄ hepatic disturbances, common bile duct ligation and DAB hepatoma were determined as to their serum 5'-N, ALP, LAP and β-G in an attempt to evaluate diagnostic value on these diseases with the following results:
1) Twenty healthy adults showed their 5'-N activity to be 6.5 ± 4. Ou.
2) Cases of acute viral hepatitis showed only a slight increase in 5'-N, while those with erythromycin estolate induced intrahepatic cholestasis showed a marked increase which proved to be were useful in evaluating challenge tests than ALP and LAP.5 '-N was favorable when used as an index for intrahepatic cholestasis.
3) Cases of inactive type of ch ronic hepatitis showed only a very slight increase in 5'-N.
4) Cases of liver cirrhosis showed a slight increase in 5: those of noncompensato ry type showed higher increase than a compensatory type, revealing an abnormal rate of 80% with their higher 5'-N than ALP.
5) Cases with p rimary liver cancer showed a slight increase and those with metastatic liver cancer a moderate increase in 5'-N, both accounting for a 100% abnormality.
6) Cases with cholelithiasis at remission showed normal 5'-N. But those with cholelithiasis 10-14 days after onset showed higher 5'-N than ALP and LAP, revealing a significant diagnostic value.
7) All cases of gastric cancer without metastasis to the liver and other showed normal enzyme activity inclusive of 5 '-N.
8) Regarding bone dseases, one case with diffuse bone metastasiis and one case of bone metastasis whose determination was made immediately before death showed a normal range of 5 '-N and ALP. Bone metastasis cases of gastric cancer and cases of bone fracture showed an increase in ALP in 87.5%, while their 5'-N was kept normal. Thus, it was considered necessary to make a simultaneous determination of 5'-N and ALP in differentiating cases of osseous ALP and liver ALP.
9) In chronological observations rats with acute CCl₄ hepatic disturbances and those of common bile duct ligation showed the highest increase in 5'-N in three days, especially in latter rats. Rats with DAB hepatoma showed a slight increase in 5 '-N, while their ALP and LAP remained normal. Thus, it was demonstrated that 5'-N in rats of common bile duct ligation and those of DAB hepatoma reflected changes in enzyme activity on a clinical basis.