liver test

Gamma-glutamyltransferase (GGT or 'gamma GT'). This is another enzyme that occurs in liver cells. A high level of this enzyme is particularly associated with heavy alcohol drinking. (The liver breaks down and clears alcohol from the body and this enzyme is involved in the process.)

AFP test

If you are not pregnant, an AFP test can help to diagnose and monitor certain liver conditions, such as liver cancer, cirrhosis, and hepatitis. It can also be used to help detect certain cancers, including cancers of the:

• testes
• ovaries
• biliary tract
• stomach
• pancreas

What tests are available for measuring AFP?

Several assays (tests) for measuring AFP are available. Generally, normal levels of AFP are below 10 ng/ml. Moderate levels of AFP (even almost up to 500 ng/ml) can be seen in patients with chronic hepatitis. Moreover, many patients with various types of acute and chronic liver diseases without documentable liver cancer can have mild or even moderate elevations of AFP.

What is the sensitivity of AFP for diagnosing liver cancer?

The sensitivity of AFP for liver cancer is about 60%. In other words, an elevated AFP blood test is seen in about 60% of liver cancer patients. That leaves 40% of patients with liver cancer who have normal AFP levels. Therefore, a normal AFP does not exclude liver cancer. AFP levels are normal in a fibrolamellar carcinoma - a variant of hepatocellular carcinoma. Also, as noted above, an abnormal AFP does not mean that a patient has liver cancer. It is important to note, however, that patients with cirrhosis and an abnormal AFP, despite having no documentable liver cancer, still are at very high risk of developing liver cancer.

An AFP greater than 500 ng/ml is very suggestive of liver cancer. In fact, the blood level of AFP loosely relates to (correlates with) the size of the liver cancer. Finally, in patients with liver cancer and abnormal AFP levels, the AFP may be used as a marker of response to treatment. For example, an elevated AFP is expected to fall to normal in a patient whose liver cancer is successfully removed surgically (resected).

ALP (Alk Phos) test:

The alkaline phosphatase test (ALP) is used to help detect liver disease or bone disorders.

• In conditions affecting the liver, damaged liver cells release increased amounts of ALP into the blood. This test is often used to detect blocked bile ducts because ALP is especially high in the edges of cells that join to form bile ducts. If one or more of them are obstructed, for example by a tumor, then blood levels of ALP will often be high.

If other liver tests such as bilirubin, aspartate aminotransferase (AST), or alanine aminotransferase (ALT) are also high, usually the increased ALP is coming from the liver. If GGT or 5'-nucleotidase is also increased, then the high ALP is likely due to liver disease. If either of these two tests is normal, then the high ALP is likely due to a bone condition. Likewise, if calcium and/or phosphorus measurements are abnormal, usually the ALP is coming from bone.

Splenomegaly( enlarged spleen)

A number of infections and diseases can contribute to an enlarged spleen. The effects on your spleen may be only temporary, depending on how well your treatment works. Contributing factors include:

• Viral infections, such as mononucleosis
• Bacterial infections, such as syphilis or an infection of your heart's inner lining (endocarditis)
• Parasitic infections, such as malaria
• Cirrhosis and other diseases affecting the liver
• Various types of hemolytic anemia — a condition characterized by premature destruction of red blood cells
• Blood cancers, such as leukemia, and lymphomas, such as Hodgkin's disease
• Metabolic disorders, such as Gaucher's disease and Niemann-Pick disease
• Pressure on the veins in the spleen or liver or a blood clot in these veins

How the spleen works

Your spleen is tucked under your rib cage next to your stomach on the left side of your abdomen. It's a soft, spongy organ that performs several critical jobs and can be easily damaged. Among other things, your spleen:

• Filters out and destroys old and damaged blood cells
• Plays a key role in preventing infection by producing white blood cells called lymphocytes and acting as a first line of defense against invading pathogens
• Stores red blood cells and platelets, the cells that help your blood clot

An enlarged spleen affects each of these vital functions. For instance, as your spleen grows larger, it begins to filter normal red blood cells as well as abnormal ones, reducing the number of healthy cells in your bloodstream. It also traps too many platelets. Eventually, excess red blood cells and platelets can clog your spleen, interfering with its normal functioning. An enlarged spleen may even outgrow its own blood supply, which can damage or destroy sections of the organ.

accuracy of routine clinical ultrasound