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SUMMARY The isoenzyme pattern of lactic dehydrogenase was measured in rectal biopsies from six patients with ulcerative colitis in whom precancerous histological changes had been independently recognized. There was a highly significant increase in the ratio of isoenzymes IV + V to I + II. This suggests that lactic dehydrogenase isoenzyme measurement may prove a valuable addition to histology in the recognition of precancer in ulcerative colitis.Longstanding ulcerative colitis has been shown in several studies (Goldgraber, Humphreys, Kirsner, and Palmer, 1958;Slaney and Brooke, 1959;Edwards and Truelove, 1964) to predispose to carcinoma of the large bowel. Subgroups of patients have been defined who are especially at risk but only a minority develop this complication. Recently Morson and Pang (1967) have described the histological criteria of precancer in rectal biopsies from patients with ulcerative colitis, which may help to identify individuals at particular risk.In the present study we have attempted to extend the work of Morson and Pang (1967) by seeking biochemical abnormalities which might correlate with this histological pattern. Such changes would be suitable for quantitation. There is evidence from studies of bronchial (Wieme, van Hove, and van der Straeten, 1968), colonic (Langvad, 1968), and uterine (Stagg, and Whyley, 1968) cancers and malignant cerebral tumours (Gerhardt, Clausen, Christensen, and Riishede, 1967) that the pattern of lactic dehydrogenase isoenzymes is abnormal in such tissues or in serum from affected patients. Normally there is a preponderance of isoenzymes I and II (which migrate rapidly on electrophoresis) over the slowmoving isoenzymes IV and V; in malignant tissues this may be replaced by a relative excess of the slow isoenzymes or of isoenzyme III.We report here our findings of lactic dehydrogenase isoenzyme distribution in rectal biopsies frompatients with ulcerative colitis, with and without histological evidence suggesting precancer, and in a control group.

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