Elevated baseline serum lactate dehydrogenase indicates a poor prognosis in primary duodenum adenocarcinoma patients.
Elevated baseline serum lactate dehydrogenase indicates a poor prognosis in primary duodenum adenocarcinoma patients.
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基线血清乳酸脱氢酶升高表明原发性十二指肠腺癌患者预后不良
DOI：
10.7150/jca.22305
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发表时间：
2018
影响因子：
3.9
通讯作者：
Xu RH
中科院分区：
文献类型：
--
作者：
Chen ZH;Qiu MZ;Wu XY;Wu QN;Lu JH;Zeng ZL;Wang Y;Wei XL;Wang F;Xu RH
目的：肿瘤细胞通过糖酵解产生能量，乳酸脱氢酶（LDH）是糖酵解的关键部分。血清LDH升高可能提示原发性十二指肠腺癌预后不良。我们的目的是探讨LDH在这种疾病中的预后意义。方法与材料：回顾性分析1996年2月至2016年1月中山癌症中心确诊为原发性十二指肠腺癌的244例患者。我们收集常规临床数据，包括基线LDH。将患者分为LDH正常组（≤245U/L）和高LDH组（>245U/L）。采用卡方检验探讨LDH水平与其他临床病理特征的相关性。通过单因素和多因素分析确定影响总生存的预后因素。结果：277例（84.9%）患者LDH水平正常，37例（15.1%）患者LDH水平异常高。LDH升高与远处转移、淋巴结转移、分化不良、TNM分期Ⅲ-Ⅳ相关（P<0.05）。淋巴结转移、分化不良、TNM分期Ⅲ-Ⅳ患者LDH中位值明显高于其他患者（P<0.05）。高LDH组患者的中位生存期明显短于正常LDH组患者（16.3 m vs. 42.5 m， P=0.02）。通过多因素分析，LDH、年龄和根治性手术是与总生存（OS）相关的独立预后因素（LDH HR=1.571， P=0.036；年龄HR=1.514， P=0.013；根治性手术HR=0.248， P<0.0001）。结论：本研究首次提示血清LDH基线是原发性十二指肠腺癌患者的独立预后因素，血清LDH基线升高提示预后不良。
Purpose: Tumour cells produce energy through glycolysis and lactate dehydrogenase (LDH) is a key part of glycolysis. Elevation of serum LDH may indicate poor prognosis in primary duodenum adenocarcinoma. We aim to explore the prognostic significance of LDH in this disease. Methods and materials: Two hundred forty-four patients diagnosed with primary duodenum adenocarcinoma who were treated at the Sun Yat-sen Cancer Center from February 1996 to January 2016 were retrospectively analysed. We collected routine clinical data, including baseline LDH. Patients were classified into a normal LDH group (≤ 245U/L) and higher LDH group (>245U/L). Correlations of the LDH level and other clinicopathological characteristics were explored using the Chi-square test. Prognostic factors for overall survival were identified using univariate and multivariate analyses. Results: Two hundred seven patients (84.9%) had normal LDH levels, while 37 patients (15.1%) had abnormally high LDH levels. Higher LDH levels were significantly associated with more distant metastasis, node metastasis, poor differentiation and TNM stage Ⅲ-Ⅳ (P<0.05). Consistently, patients with node metastasis, poor differentiation and TNM stageⅢ-Ⅳ had a significantly higher median LDH level (P<0.05). The median survival of patients in the higher LDH group was significantly shorter than that of the patients in the normal LDH group (16.3 m vs. 42.5 m, P=0.02). Using multivariate analysis, LDH, age and radical surgery were independent prognostic factors associated with overall survival(OS) (HR=1.571, P=0.036 for LDH; HR=1.514, P=0.013 for age; HR=0.248, P<0.0001 for radical surgery, respectively). Conclusions: For the first time, our research suggests that baseline serum LDH is an independent prognostic factor in primary duodenum adenocarcinoma patients and elevated baseline serum LDH indicates a poor prognosis.
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