What causes high fucosidase levels?

Fucosidase is an acidic hydrolase distributed in the tissue cells of the human body. It is generally used to participate in the metabolism of glycoproteins and glycolipids. If the fucosidase level is elevated, it is likely to be primary liver cancer, but it is not necessarily the case. Other diseases may also cause elevated fucosidase. If you want a confirmed diagnosis, it is best to go to a regular tertiary hospital. What are the general reasons for elevated fucosidase?

Liver cancer: The AFU activity in the serum of patients with primary liver cancer is not only significantly higher than that of normal controls, but also significantly higher than that of metastatic liver cancer, cholangiocarcinoma, malignant mesothelioma, malignant hemangioendothelioma, cirrhosis, congenital liver cysts and other benign liver space-occupying lesions. The positive rate for diagnosis of primary liver cancer is 64%-84%, and the specificity is about 90%. By testing AFU and AFP in patients with primary liver cancer and liver cirrhosis, it was found that the AFU and AFP levels in patients with primary liver cancer and liver cancer after cirrhosis were increased. Taking AFP500ng/mL as the critical value for diagnosing liver cancer, the false positive rate was 43%. Taking AFU740nmol/(ml.h) as the critical value, the sensitivity was 84% ​​and the specificity was 94%. Therefore, serum AFU has high sensitivity and specificity for the diagnosis of primary liver cancer. A domestic study on the correlation between serum AFU and AFP in 24 patients with hepatocellular carcinoma found that the diagnostic sensitivity of AFU was 87% and the specificity was 78%, while those of AFP were 65% and 89%, respectively (diagnostic limit was 20ug/L). This suggests that AFU has a better sensitivity in diagnosis, but a lower specificity than AFP. There was no significant correlation between serum AFU activity and positive rate and the diameter of liver cancer. The serum AFU positive rate in the small hepatocellular carcinoma group was 70.8%, which was significantly higher than that of AFP (37.5%). The positive rate of serum AFU in patients with negative AFP or elevated AFP but not enough to diagnose primary liver cancer was 80.8%. In patients with primary liver cancer confirmed by liver tissue biopsy, the positive rate of serum AFU is more than three times that of AFP. In patients with cirrhosis, AFU detection, if its activity increases, is more valuable in detecting some smaller tumors, while AFP cannot diagnose smaller tumors. Therefore, the application and promotion of AFU as a new diagnostic indicator for primary liver cancer is of great significance, especially for AFP-negative and small cell liver cancer. Because there is no obvious correlation with AFP and they can be used for initial diagnosis, combined testing can increase the detection rate of liver cancer.

Pregnancy and ovarian tumors: Studies have shown that plasma AFU increases with the number of weeks of pregnancy, and then decreases rapidly after natural delivery or artificial termination of pregnancy, returning to normal within 5 days. Serum AFU activity is decreased in patients with ovarian cancer and is not associated with disease stage, tumor burden, histological type, and tumor differentiation. The decrease in serum AFU activity in patients with benign and malignant ovarian cancer may be related to genetic factors

Others: Patients with fucosidase storage have congenital AFU deficiency or reduced activity in tissues, organs and body fluids, leading to glycoprotein or glycolipid metabolism disorders. The serum AFU level is elevated in patients with gastric cancer, but not in patients with acute pancreatitis. It is decreased in patients with cystic fibrosis and pancreatitis, and the serum AFU activity is decreased in patients with progressive pyramidal dystrophy.

81.2% of patients with primary liver cancer have elevated serum AFU levels. Combined detection with AFP can increase the positive diagnostic rate of primary liver cancer to 93.1%.

Dynamic observation is of great significance for judging the efficacy, prognosis and recurrence of liver cancer.

Serum AFP may also increase in metastatic liver cancer, lung cancer, breast cancer, ovarian cancer, and uterine cancer; it may also increase slightly in cirrhosis, chronic hepatitis, gastrointestinal bleeding, etc.