Value of serum-5-nucleotidase, alkaline phosphatase and gamma-glutamyl transferase for prediction of liver metastases preoperatively in colorectal cancer.

In 133 patients laparotomized for colorectal cancer the serum-5-nucleotidase, alkaline phosphatase and gamma-glutamyltransferase were analysed preoperatively. The presence of liver metastases was established at laparotomy by palpation (prevalence 19%). The serum enzyme levels were elevated in 10-18% of patients without liver metastases and in 48-64% of patients with liver metastases. A comparison of the estimated tumor volume in the liver and the serum enzyme levels was performed. The predictive values of the three tests were computed at different reference limits. It was concluded that none of the tests used had any advantage of the other. To increase the diagnostic yield another reference limit than the normal at the laboratory can be used.