[Liver function assessment in oncology practice].

Area of Science:

• Hepatology
• Oncology
• Clinical Chemistry

Background:

• Impaired liver function significantly impacts patient prognosis and treatment outcomes in oncology, affecting pharmacotherapy, surgery, and radiological interventions.
• Standard clinical practice relies on laboratory tests and physical examinations to assess liver condition.
• Key laboratory markers include aminotransferases, bilirubin, alkaline phosphatase, gamma glutamyl transpeptidase, lactate dehydrogenase, albumin, and prothrombin time, with others like prealbumin and cholinesterase used less frequently.

Purpose of the Study:

• To provide a comprehensive overview of liver function tests (LFTs) and their clinical utility, particularly in the context of oncology.
• To highlight the diagnostic and prognostic value of specific LFTs for liver damage, cholestasis, and synthetic function.
• To discuss advanced methods for liver function quantification relevant to surgical planning.

Main Methods:

• Review of common laboratory tests used for liver function assessment, including markers for liver damage (alkaline phosphatase, aspartate transaminase), cholestasis (alkaline phosphatase, gamma glutamyl transpeptidase), and synthetic function (albumin, prealbumin, cholinesterase, prothrombin time).
• Discussion of tests evaluating liver transport and excretory capacity (bilirubin, bile acids).
• Inclusion of prognostic scores like Child-Pugh and advanced quantitative methods such as indocyanine green examination and mathematical analysis of dynamic cholescintigraphy.

Main Results:

• Specific liver tests serve distinct roles: alkaline phosphatase and aspartate transaminase indicate liver damage, while alkaline phosphatase and gamma glutamyl transpeptidase are key for cholestatic injury.
• Albumin, prealbumin, cholinesterase, and prothrombin time reflect the liver's synthetic capacity.
• Bilirubin and bile acids are associated with the liver's transport and excretory functions.
• The Child-Pugh score aids in assessing chronic liver disease prognosis, and indocyanine green tests quantify function for surgical decisions.

Conclusions:

• A range of laboratory tests effectively assesses liver function, providing critical information for patient management in various medical fields, including oncology.
• Advanced quantitative methods offer precise evaluation of liver function, essential for planning interventions like liver resection.
• While many LFTs are valuable, their specific utility varies, with some tests being more relevant in oncology than others.