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The monoethylglycinexylidide test for grading of liver cirrhosis
Author(s) -
Luca Fabris,
Jemmolo Rm,
Gianna Toffolo,
D. Paleari,
S. Viaggi,
Michele Rigon,
F. Casagrande,
Flavio Lirussi,
Mario Strazzabosco,
Claudio Cobelli,
Lajos Okolicsányi
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00431.x
Subject(s) - medicine , cirrhosis , gastroenterology , liver function tests , liver function , receiver operating characteristic , grading (engineering) , civil engineering , engineering
Background: Monoethylglycinexylidide (MEGX) formation following lignocaine injection has recently been proposed as a simple dynamic liver function test based on a single measurement of its serum concentration. Aim: To determine the optimal sampling time for MEGX determination. Methods: A modelling analysis of lignocaine and MEGX kinetics was performed in seven normals and in four patients with compensated liver cirrhosis; a similar study was performed in 74 cirrhotic patients, divided into two groups according to disease severity (Pugh score). Results: Only the MEGX fractional formation rate (k f ) and formation delay (τ) were significantly altered in cirrhotic patients compared to normals: k f = 0.15 ± 0.03 vs. 0.32 ± 0.10 min −1 (mean ± s.d.); τ = 7.7 ± 2.0 vs. 3.9 ± 2.9 min −1 . A good correlation was found between k f and late ( r = 0.82) but not early ( r = 0.63) serum MEGX formation, suggesting that late measurements for the clinical MEGX test are preferred. In the second part of our investigation, by discriminant analysis of MEGX test data for 74 cirrhotic patients, the late MEGX concentrations gave the best discrimination between the two classes. In particular, the 60 min MEGX concentration showed the best diagnostic accuracy (81%), sensitivity (75%) and specificity (84%). The association of this with other MEGX parameters, either singly or derived from the whole curve measurements, did not improve the performance of the method. Conclusion: The MEGX test, based on a single determination 60 min after lignocaine injection, may be regarded as a simple and sensitive quantitative liver function test.