1Postgraduate student, Department of Biochemistry and Microbiology, Faculty of Pharmacy, Tishreen University, Lattakia, Syria
2Assistant Professor, Department of Internal Medicine and Heamatology, Faculty of Medicine, Tishreen University, Lattakia, Syria
Cancer is defined as a group of diseases, It involve abnormal cell growth with the potential of invade and spread, it also involve with metabolic changes such as a metabolic switch from oxidative phosphorylation to increased glycolysis, even under normal oxygene conditions, this phenomenon is termed the Warburg effect[6]. Lactate dehydrogenase (LDH) is a metabolic enzyme widely expressed in almost all tissues and is detectable in serum, which catalyzes the interconversion of pyruvate and lactate during glycolysis and gluconeogenesis, and is considered to be a key checkpoint of anaerobic glycolysis. LDH levels is elevated in many types of cancer in compare to normal tissues, and it has been linked to tumor growth, maintenance, and invasion; This enzyme is receiving a great deal of attention as a potential diagnostic marker or a predictive biomarker for many types of cancer and as a therapeutic target for new therapies.[5] Lactate dehydrogenase (LDH) is regulated by the phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin (mTOR)-containing complex 1 (PI3K/Akt/TORC1) pathway as well as tumor hypoxia induced factor (HIF1). This study aimed to investigate whether lactate dehydrogenase (LDH) level in diagnostic is a marker of hypoxia, had clinical value in determining the kind of cancer or the stage of the disease in pretreatment cancer patients.[7, 9]
We evaluated pretreatment serum lactate dehydrogenase (LDH) in 285 newly diagnosed cancer patients. the study samples included both men and women, It also included all kind of cancer.
The Shapiro-Wilk test was used to determine the distribution of continuous variables. Student's t-test, Mann-Whitney U test, chi square, and Ficher exact test were used too.[2]
Baseline LDH levels 210 IU/L was an independent prognosticator for recurrence-free survival The predictive value of baseline LDH value remained significant in the subgroup analysis. LDH level <227 IU/L was identified as an independent predictor of complete remission after treatment. It helps distinguish patients with different prognosis and select patients who are more likely to benefit from normal treatment regimens. A highly significant difference was found between the survival patterns of patients with LDH levels of 233 U or less and those with LDH levels greater than 233 U. (recurrence free survival rates were 63% and 74%, respectively.
The association of LDH level with the stage of the disease in Lung cancer, Brest cancer, Germcell cancer (prostate and testicular cancer, ovarian and uterus cancer), lymphoma and leukemia was evident even after adjustment for other factors that might affect the diagnosis. Pretreatment serum LDH determinations may provide a useful means of staging in cancer types mentioned previously.[30]
Cancer, Lactate dehydrogenase, metabolism, anaerobic analysis
