Diagnostic Value of Serum Gamma-Glutamyl Transpeptidase Activity and Isoenzyme Pattern in Patients with Pancreatic Cancer

Abstract

Fourteen cases of pancreatic cancer were subjected to detailed study on serum y-glutamyl transpeptidase (GT). Increased GT level has been observed in all cases of pancreatic cancer and the increase was found to be more pronounced when jaundice was present. Agar gel electrophoresis revealed the presence of three isoenzyme bands, i.e. named GT-1, GT-II and GT-III from anode side. In case of pancreatic cancer GT-II was found to be dominant and thus GT-I/GT-II ratio being always smaller than unity. In contrast, the augmentation of GT-I with the resulting GT-I/GT-II ratio over 1.0 was found to be associated with chronic pancreatitis as well as with normal subjects. Appearance of GT-III was seen when obstructive jaundice was present and they are probably closely associated.
Diagnosis of pancreatic cancer in its early stage, when jaundice is still absent, is of serious diagnostic problem. When used in combination with newer diagnostic procedures such as pancreatic scintigraphy, celiac angiography and endoscopic pancreatography, malignancy pattern in GT isoenzyme will offer a great help in differenting between benign and malignant pancreatic disease.