Causes of liver test abnormalities in newly diagnosed cancer patients and the investigation of etiological factors

Postgrad Med. 2024 Mar;136(2):162-168. doi: 10.1080/00325481.2024.2316571. Epub 2024 Feb 23.


Objectives: In this study, we aimed to investigate the causes of liver test abnormalities in newly diagnosed patients naive to anti-tumoral therapy.

Method: This study included a total of 490 patients with ALT levels > 5X ULN on liver function tests at the initial presentation to our clinic. Data from 247 (50.4%) patients diagnosed with cancer (cohort A) and 243 (49.6%) patients without cancer (cohort B) were compared with regard to the etiology of liver test abnormalities and the risk factors.

Results: The most common etiological factor in cohort A was presence of liver metastasis (31.2%, n = 77). In the comparison of the two groups with regard to etiological factors; the rates of liver metastasis [31.2% vs 0%, (p < 0.001)], drug-induced liver toxicity [30/4% vs 19.8%, (p = 0.007)], pancreaticobiliary pathology [21.5% vs 14%, (p = 0.03)] and chronic viral hepatitis [14.2% vs 7.4%, (p = 0.02)] were higher in the cohort A. The rate of NAFLD was higher in the cohort B [6.9% vs 42.2% (p < 0.001).

Conclusion: In our study, the most common cause of liver test abnormalities was the presence of liver metastasis in cohort A and NAFLD in cohort B.

Keywords: Cancer; alanine aminotransferase; liver function tests; liver metastasis; liver test abnormalities.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / etiology
  • Female
  • Humans
  • Liver Function Tests* / methods
  • Liver Neoplasms* / secondary
  • Male
  • Middle Aged
  • Neoplasms
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Retrospective Studies
  • Risk Factors


  • Alanine Transaminase