engleski

The value of plasma cholinesterase activity in children with hepatoblastoma

Introduction: Hepatoblastoma is a rare malignant pediatric liver tumor and alpha- fetoprotein (AFP) is the currently used diagnostic serum marker. Plasma cholinesterase (PChE, EC 3.1.1.8) is also a protein synthesized in the liver and its activity is affected by many physiological and pathological conditions. Our aim was to evaluate the possible role of PChE as an indicator of liver function. Patients and methods: During 20 years period, in 18 pediatric patients (12 boys, 6 girls), ages range from 4 month to 5 years we confirmed the diagnose after complete physical and laboratory tests, ultrasonography, computerized tomography and histological analysis. In 12 children (stage I and stage II) the tumor was completely resected and in 6 children (stage III and stage IV) only liver biopsies could be done. In all patients we measured PChE before surgical intervention and 3 weeks after. Plasma samples (20 ml) were collected and stored at -20 °C until analysed. PChE activty was determined by the spectrophotometric method of Ellman et al., using butyrylcholine as substrate (Sigma Chem Co.St Louis, USA). Twenty healthy children undergoing elective inguinal hernia repaire aged from 1-10 years were included in the control group. Statistical analysis was made by SPSS method. Results: There is a significantly different value of PChE activity in all patients with hepatoblastoma (independently of the stage of the disease) in relation to the PChE of control value. Second, there is significantly different value of PChE activity between two groups of patients (stage I and II vs stage III and IV) before any surgical intervention. Third, our results show that children with resectable hepatoblastoma have significantly lower activity of PChE in relation to the value measured 3 weeks after surgical treatment. In patients without operative treatment, 3 weeks after liver biopsy the PChE activity was significantly lower following disease progression. Conclusion: Our results indicate a decreased synthesis of PChE in all children with hepatoblastoma. Significantly higher PChE values 3 weeks after removal of the tumor show liver function recovery. In children with inoperable tumor (3 weeks after) we measured decreased PChE values. The results show the influence of hepatoblastoma on the PChE synthesis. PChE activity can be a prognostic marker of liver function and recovery as well as another laboratory parameter in diagnosing hepatoblastoma.

plasma cholinesterase; hepatoblastoma; children

nije evidentirano