Serum gamma-glutamyltransferase and alkaline phosphatase during experimental liver metastases. Detection of tumour-specific isoforms and factors affecting their serum levels.

Tumour-specific isoenzymes and tumour markers in serum are potentially useful in the detection and monitoring of liver metastases. An experimental rat model was used in the search for such isoenzymes and to study factors affecting their serum levels. Splenic injection of CC531 colon carcinoma cells in syngeneic WagRij rats caused liver metastases after 3 weeks with concomitant and significant increases in serum levels of gamma-glutamyltransferase (GT) and alkaline phosphatase (ALP). The presence of tumour-specific isoforms of both enzymes, as well as increased amounts of the liver isoform of ALP, were demonstrated in serum. The serum levels of the tumour variants were clearly related to their elimination rates from the circulation. Thus, the slow clearance of the tumour ALP resulted in high serum levels of this isoform, compared with the more rapid elimination of tumour GT and its lower serum level. When using another colon carcinoma cell line (DHD/K12), metastatic to liver in BD IX rats, no increases in serum GT were detected. This was related to the rapid elimination from the circulation of the GT variant from the DHD/K12 metastatic tissue. The relatively high amount of the tumour ALP isoform detected in serum during growth of the CC531 liver metastases indicated that this isoform could be useful as a marker of tumour growth.