Prognostic value of combined preoperative lactate dehydrogenase and alkaline phosphatase levels in patients with resectable pancreatic ductal adenocarcinoma

Abstract

Serum enzymes, including lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), have recently been reported to play important roles in tumor growth. Increases in LDH and ALP have been confirmed to predict poor prognosis in patients with various cancers. However, their prognostic value in pancreatic cancer has not been well studied. Therefore, we reviewed the preoperative data on LDH and ALP in 185 pancreatic ductal adenocarcinoma (PDAC) patients who underwent surgery between July 2005 and December 2010 to explore the prognostic value of these markers. The cutoff points were determined based on the upper limit of their normal values. The Chi-square test was used to analyze the relationships between LDH/ALP and clinical characteristics. Univariate and multivariate analyses were performed to identify the predictive value of the above factors for disease-free survival (DFS) and overall survival (OS). We found that elevation of LDH was related to carbohydrate antigen 19-9 (CA19-9), lymph node involvement, tumor size, TNM, distant metastasis, and recurrence. Additionally, ALP was correlated to perineural invasion. After multivariate analysis, LDH and ALP were identified as independent prognostic factors for DFS and OS, and elevation of LDH/ALP was correlated with poor DFS and OS. Notably, there was a positive correlation between LDH and ALP. The predictive power of LDH combined with ALP was more sensitive than that of either one alone. Therefore, we conclude that the preoperative LDH and ALP values are prognostic factors for PADC, and the prognostic accuracy of testing can be enhanced by the combination of LDH and ALP

Prognostic significance of serum alkaline phosphatase and lactate dehydrogenase levels in patients with unresectable advanced gastric cancer

“…We found that high ALP levels independently predict poor prognosis in patients with unresectable advanced gastric cancer, indicating that such levels could be used to reflect clinical prognosis. These findings support previous studies that proposed ALP or LDH as prognostic markers in hepatocellular carcinoma, esophageal squamous cell carcinoma, nasopharyngeal carcinoma, and pancreatic carcinoma [7,8,[16][17][18][19]. This is the first study to demonstrate the relationship between ALP levels and prognosis in gastric cancer patients.…”

“…Recently, some investigators reported that ALP and LDH appeared to be reliable parameters to predict prognosis for various malignancies such as pancreatic cancer or esophageal squamous cell carcinoma [7,8]. However, the influence of serum enzymes such as ALP and LDH has not been reported in gastric cancer patients with regard to prognosis.…”

Prognostic value of γ‐glutamyltransferase‐to‐albumin ratio in patients with pancreatic ductal adenocarcinoma following radical surgery

“…Liver function test is a basic routine examination before surgery. Some of its components, including alanine aminotransferase (ALT), albumin (ALB), and alkaline phosphatase (ALP), have been shown to have prognostic values for postoperative pancreatic cancer patients . Therefore, to provide better prognostic indicators in patients with resectable pancreatic cancer, it is of interest to further dig into parameters of liver function test and identify potential preoperative biomarkers that can predict postoperative survival.…”

A laktátdehidrogenáz (LDH) prognosztikai jelentősége az onkológiában

“…Hasnyálmirigyrákban (n = 185) a kiindulási LDH<240 U/l hosszabb egy-, három-és ötéves betegségmentes túléléssel korrelált (60%, 26,8%, 19,9% vs. 22,2%, 5,2%, 2,6%, p<0,001) [105].…”