Volume 38, Issue 1, Pages 45-49 (January 2006) Serum cytokeratins in alcoholic liver disease: contrasting levels of cytokeratin-18 and cytokeratin-19  A. Gonzalez-Quintela, J. García, J. Campos, L.F. Perez, M.R. Alende, E. Otero, I. Abdulkader, S. Tomé  Alcohol  Volume 38, Issue 1, Pages 45-49 (January 2006) DOI: 10.1016/j.alcohol.2006.01.003 Copyright © 2006 Elsevier Inc. Terms and Conditions

Fig. 1 Boxplot of (A) serum CYFRA 21-1 (CK-19) levels and (B) serum TPS (CK-18) levels in healthy controls, patients with malignancy, and heavy drinkers with alcoholic liver disease. Horizontal solid lines represent median values, boxes represent interquartile ranges, whiskers represent ranges, and scattered dots represent outliers (values 1.5 times higher than the interquartile range). The horizontal dashed line represents the upper normal reference value. Note that the ordinate axis is in logarithmic scale. CK = cytokeratin. Alcohol 2006 38, 45-49DOI: (10.1016/j.alcohol.2006.01.003) Copyright © 2006 Elsevier Inc. Terms and Conditions

Fig. 2 Boxplot of (A) serum CYFRA 21-1 (CK-19) levels and (B) serum TPS (CK-18) levels in heavy drinkers with fatty liver and alcoholic hepatitis. The patient from the series with alcoholic cirrhosis (TPS value 320U/l, CYFRA 21-1 value 0.763ng/ml) is not represented. Horizontal solid lines represent median values, boxes represent interquartile ranges, whiskers represent ranges, and scattered dots represent outliers (values 1.5 times higher than the interquartile range). The horizontal dashed line represents the upper normal reference value. CK = cytokeratin. Alcohol 2006 38, 45-49DOI: (10.1016/j.alcohol.2006.01.003) Copyright © 2006 Elsevier Inc. Terms and Conditions

Fig. 3 Contrasting CK-19 and CK-18 liver immunoreactivity in a representative case of alcoholic hepatitis. The biopsy corresponds to a 45-year-old female who was admitted to the hospital with alcohol withdrawal syndrome. Serum level of AST was 84U/l, ALT 44U/l, GGT 458U/l, total bilirubin 1.1mg/dl, prothrombin index 83%, CYFRA 21-1 (CK-19) 2.02ng/ml, and TPS (CK-18) 4131U/l. Similar slides are stained as follows: (A) Standard hematoxilin–eosin staining. Inflammatory cells and fibrosis are observed, as well as hepatocyte steatosis, necrosis, and extensive Mallory's hyaline degeneration. (B) CK-19 staining. Reactivity is nearly restricted to the normal staining of biliary ducts. Only few scattered hepatocytes show tiny cytoplasmic reactivity (arrowheads). (C) CKs-8/18 staining. Many hepatocytes are strongly reactive, either diffusely or in clumps, which correspond to Mallory bodies. Original magnifications, ×200. CK = cytokeratin. Alcohol 2006 38, 45-49DOI: (10.1016/j.alcohol.2006.01.003) Copyright © 2006 Elsevier Inc. Terms and Conditions