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  • Title: The role of gamma-glutamyl transpeptidase in the preoperative metastatic evaluation of renal cell carcinoma.
    Author: Sandock DS, Seftel AD, Resnick MI.
    Journal: J Urol; 1997 Mar; 157(3):798-9. PubMed ID: 9072569.
    Abstract:
    PURPOSE: We evaluated gamma-glutamyl transpeptidase as an indicator of metastatic disease in patients with renal cell carcinoma. MATERIALS AND METHODS: We reviewed the records of 53 patients with metastatic renal cell carcinoma, and compared serum alkaline phosphatase and gamma-glutamyl transpeptidase with the site of metastases. These results were then compared to those in 29 patients with clinically localized renal cell carcinoma. RESULTS: Overall gamma-glutamyl transpeptidase was elevated in 37 patients (69.8%) with metastatic disease, while alkaline phosphatase was elevated in 16 (30.2%, p < 0.025). Gamma-glutamyl transpeptidase was increased in more patients with hepatic metastases only than alkaline phosphatase (p < 0.025) and in all groups it was a better predictor of metastases than alkaline phosphatase. Gamma-glutamyl transpeptidase was also increased in significantly more patients with metastatic renal cell carcinoma (37 of 53) compared to 1 of the 27 with localized renal cell carcinoma (p < 0.001). CONCLUSIONS: Gamma-glutamyl transpeptidase was increased in a large percent of patients with metastatic renal cell carcinoma, and it was normal in the majority with localized renal cell carcinoma. We conclude that gamma-glutamyl transpeptidase should be included as well as alkaline phosphatase in the preoperative metastatic evaluation of patients with renal cell carcinoma. Elevated gamma-glutamyl transpeptidase should prompt a search for bone as well as liver metastases.
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