Author/Authors :
Igor Kaierman، نويسنده , , Radgonde Amer، نويسنده , , Jacob Peʹer، نويسنده ,
Abstract :
Purpoe
To evaluate trend in liver function tet before detection of liver metatae from uveal melanoma.
Deign
Retropective, comparative, obervational cae control tudy.
Method
etting: The Irael uveal melanoma center at the Hadaah Univerity Hopital. Patient Population: A total of 307 uveal melanoma patient who were diagnoed with uveal melanoma and followed between the year 1988 and 1998. Of them, 30 metatatic patient who had regular follow-up by liver function tet (LFT) and liver imaging were included in thi tudy. Eighty nonmetatatic patient were randomly choen a control. Obervation Procedure: The medical record of the metatatic and control group were reviewed documenting LFT and liver imaging reult. Main Outcome Meaure: The mean level of each LFT, it enitivity, pecificity, and likelihood ratio at variou time period before the detection of metatae by liver imaging.
Reult
At the time of diagnoi of liver metatae by imaging, 50% of patient had at leat one abnormal LFT (compared with only 5% of the control group). While no change wa noted in the mean erum level of bilirubin, mean lactate dehydrogenae (LDH), alkaline-phophatae, gamma glutamyl tranpeptidae (γGTP) apartate-aminotraferae, and alanine-aminotraferae level eem to rie, even within normal limit, during the 6 month before the detection of metatae. Baed on likelihood ratio, alkaline-phophatae and lactate dehydrogenae were the mot predictive tet. Lactate dehydrogenae and apartate-aminotranferae were already predictive at 80% of the upper normal limit, wherea alkaline-phophatae and γ-glutamyltranferae were mot predictive at the upper normal limit.
Concluion
Monitoring the change in elected LFT, even within normal limit, can help predict metatatic uveal melanoma.