SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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S Stankovic1 , P Svorcan2 , Nj Jojic2 , B Radevic3 , N Majkic-Singh1 , B Dapcevic2

1Institute of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia &Montenegro , 2Department of Gastroenterohepatology, Zvezdara University Hospital, Belgrade, Serbia &Montenegro, 3Dedinje Institute of Cardiovascular Diseases, Belgrade, Serbia &Montenegro

There are two types of quantitative tests for the assessment of the liver functional state: elimination tests and tests based on the detection of a certain substance metabolite, which is metabolized in hepatocytes. Monoethylglycinexylidede (MEGX) is the primary metabolite of lidocaine. The quantitative measurement of lidocaine metabolism can serve as a sensitive indicator of the liver function. The galactose elimination capacity (GEC) test represents functional hepatic mass. The aim of this study was to assess the usefulness of MEGX and GEC tests for a preoperative assessment of the liver functional capacity and as prognostic index of postoperative survival in patients with hepatocellular carcinoma (HCC). MEGX and GEC levels were measured in a group of 23 patients (male/female 17/6, mean age 62) with HCC and 10 healthy volunteers (male/female 6/4, mean age 49). All of them received a single bolus dose of lidocaine (1mg/kg body mass weight) and blood samples were drawn 15 min after. Serum MEGX was determined by commercial kit (Abbott), using TDX system (Abbott). Patients and controls were administered with a single bolus dose of D-galactose (iv. 0.5 g/kg body mass weight) and blood samples drawn after 20, 30, 40 and 45 min. Galactose concentration was determined by commercial test (Roche Diagnostics). Our results demonstrate that there was statistically significant difference (p < 0.001) between patients and controls in MEGX (46.13±20.49 vs. 95.10±20.71 ng/mL) and GEC (6.10±1.23 vs 7.32±0.39 mg/min/kg). Patients with MEGX values lower than 25 ng/mL and GEC values lower than 5.5 mg/min/kg had significantly shorter postoperative survival (p < 0.01). Our hitherto obtained results show that MEGX and GEC as an index in evaluating hepatic function and postoperative survival are reliable, reproducible and easily performed. These tests should be used for preoperative assessment residual hepatic capacity in patients with HCC and for identifying patients with worse prognosis.

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