Diagnostic value of prealbumin and retinol-binding protein in acute and chronic liver diseases.

Prealbumin (PA) and retinol-binding protein (RBP) serum concentrations have been determined in 161 patients with different chronic and acute liver diseases and in 49 healthy controls. Their possible role in clinical practice as liver markers of hepatic biosynthesis in comparison with other traditional tests: albumin, pseudocholinesterase and clotting factors II, VII and X associated activity (Hepato-Quick) was investigated. PA and RBP were always highly intercorrelated and significantly decreased in acute viral hepatitis, steatosis, chronic persistent and active hepatitis, cirrhosis, hepatic tumors and primary biliary cirrhosis. Among the different tests, PA and RBP presented the best values of specificity (0.98 and 0.97, respectively), sensitivity (0.77 and 0.73) and positive (0.99) and negative prediction (0.57 and 0.46). In chronic liver diseases PA and RBP distinguished more efficiently than the other biosynthetic markers among diseases with different degree of severity. In acute viral hepatitis the behavior of PA and RBP, followed for 4 consecutive weeks, was similar to that of Hepato-Quick and better than the other tests in reflecting the clinical course of the disease.