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Original ArticleOpen Access
Fast Liver Alkaline Phosphatase Isoenzyme in Diagnosis of Malignant Biliary Obstruction
Paritpokee N 
,
Tangkijvanich P ,
Teerasaksilp S ,
Wiwanitkit V ,
Lertmaharit S ,
Tosuklwwong P
,
Tangkijvanich P ,
Teerasaksilp S ,
Wiwanitkit V ,
Lertmaharit S ,
Tosuklwwong P Fast liver alkaline phosphatase isoenzyme was measured by cellulose acetate electrophoresis
in the sera obtained from 84 patients with specific hepatobiliary diseases and 10 control
subjects. The mean value of this isoenzyme in patients with malignant extrahepatic obstruction
was 130.58± 107.08 U/L, significantly higher than that of patients with benign extrahepatic
obstruction (65.63±34.14 U/L), as well as patients with intrahepatic cholestasis and infiltrative
liver cancers (65.31±38.11 U/L and 48.47±36.85 U/L, respectively). Furthermore, we could
not detect this isoenzyme in normal individuals. When 100 U/L was used as a cut-off value to
discriminate between patients with malignant extrahepatic obstruction and the remaining hepatobiliary
disorders, the sensitivity, specificity and accuracy of the test were 63 per cent, 84 per cent
and 80 per cent, respectively. It is concluded that the fast liver isoenzyme could be a useful
marker in diagnosis of malignant extrahepatic obstruction.
Key word : Alkaline Phosphatase, Isoenzymes, Jaundice, Liver Disease, Biliary Tract Disorders
in the sera obtained from 84 patients with specific hepatobiliary diseases and 10 control
subjects. The mean value of this isoenzyme in patients with malignant extrahepatic obstruction
was 130.58± 107.08 U/L, significantly higher than that of patients with benign extrahepatic
obstruction (65.63±34.14 U/L), as well as patients with intrahepatic cholestasis and infiltrative
liver cancers (65.31±38.11 U/L and 48.47±36.85 U/L, respectively). Furthermore, we could
not detect this isoenzyme in normal individuals. When 100 U/L was used as a cut-off value to
discriminate between patients with malignant extrahepatic obstruction and the remaining hepatobiliary
disorders, the sensitivity, specificity and accuracy of the test were 63 per cent, 84 per cent
and 80 per cent, respectively. It is concluded that the fast liver isoenzyme could be a useful
marker in diagnosis of malignant extrahepatic obstruction.
Key word : Alkaline Phosphatase, Isoenzymes, Jaundice, Liver Disease, Biliary Tract Disorders
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