DOI: 10.14260/jemds/2014/2132 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 3/ Issue 09/ Mar 3, 2014 Page 2236 SERUM ENZYMES IN HEPATOBILIARY CARCINOMA Priyanka Sharma 1 , Mili Gupta 2 , Gitanjali Goyal 3 , Kiranjit Kaur 4 HOW TO CITE THIS ARTICLE: Priyanka Sharma, Mili Gupta, Gitanjali Goya, Kiranjit Kaur. “Serum Enzymes in Hepatobiliary Carcinoma”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 09, March 03; Page: 2236-2244, DOI: 10.14260/jemds/2014/2132 ABSTRACT: INTRODUCTION: Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. Hepatic metastasis occurs in 40-50% of adult patients with extrahepatic primary malignancies. The levels of enzymes alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT) and leucine aminopeptidase (LAP) are deranged in pathological conditions. AIM: To study and compare the serum enzymes Alkaline phosphatase (ALP), Gamma-glutamyl transpeptidase (GGT) and Leucine aminopeptidase (LAP) in cases of hepatobiliary carcinoma. METHODOLOGY: 30 patients diagnosed with heptobiliary carcinoma were enrolled for the study and 50 healthy individuals of matched age and sex served as controls. Serum Leucine Aminopeptidase (LAP), Alkaline Phosphatase (ALP) and Gamma-glutamyl Transpeptidase (GGT) were determined and compared in study and control groups. RESULTS: The mean levels of serum ALP, GGT and LAP in the study group were 786.3±465.05 IU/L, 193.3±116.73 IU/L and 96.86±34.74 IU/L respectively. These values were significantly higher than in the control groups. Serum LAP showed abnormal levels in maximum number of cases (93.3%) followed by serum GGT in 83.3% and serum ALP in 76.6% cases. ALP, GGT and LAP levels were significantly higher in icteric and nonicteric groups as compared to control group. CONCLUSIONS: Serum ALP, GGT and LAP were significantly elevated in the patients with hepatobiliary carcinoma and the elevations were significantly higher in icteric as compared to nonicteric groups. Serum LAP is a better indicator of hepatobiliary carcinoma. KEYWORDS: ALP, GGT, LAP, Hepatobiliary Carcinoma. INTRODUCTION: Hepatobiliary carcinoma includes carcinoma of liver, pancreas, bile ducts, ampulla of Vater and gall bladder. Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. It is the fourth most common cancer in the world 1 . Metastases are the most common malignant tumors of the liver 2 . Metastasis of liver is commonest ranking second only to cirrhosis as a cause of liver damage. The incidence of carcinoma of the pancreas has markedly increased over the past several decades and ranks as the fourth leading cause of cancer death in the United States 3 . In pathological conditions there is usually some derangement in the metabolic processes which is reflected by a change in enzymatic patterns. The detection of these biochemical agents is simple and noninvasive. Leucine aminopeptidase (LAP, 3.4.11.1), a proteolytic enzyme, is capable of hydrolyzing L- Leucyl peptides and is primarily involved in protein digestion in small intestine mucosa. LAP is widely distributed in bacteria, plants and distributed in all human tissues with high activity in liver as well as in duodenum, small intestine, pancreas, testis and stromal cells of the uterus 4 . This enzyme is an integral membrane glycoprotein located to apical domain of intestinal epithelial cells. Serum alkaline phosphatase (ALP, 3.1.3.1) is a phosphomonoesterase, which has a widespread distribution in body tissues and is also synthesized in the ductal epithelium in liver. Elevation of serum alkaline phosphatase in liver disease occurs primarily in cholestatic disorders. Gamma glutamyl