Study of Serum Lactate Dehydrogenase and Gamma-Glutamyl Transpeptidase in Breast Cancer Patients receiving Chemotherapy

Abstract

Breast cancer (BC) is the most common type of cancer worldwide, being one of the leading causes of morbidity in the female. In Nepal, it is the second most common type of cancer among women of perimenopausal age group. More than one-quarter of the BC is diagnosed in young Nepalese female, with a familial history of breast cancer, early pregnancy, longer lactation and estrogen exposure, often tumors showing aggressive biological behaviors. Anthracyclines (Doxorubicin) based treatment regime were reported to cause cardiotoxicity by increasing intramyocardial free radical production, lipid alterations and decreasing antioxidant level. Oxidative stress involving cellular reactive oxygen species (ROS) production is widely accepted mechanism, but the molecular basis of chemotherapyinduced organ toxicity remains highly controversial. An increased rate of metabolism and oxidative stress results in rapid turnover of cancer cells that modulates the enzyme level in blood circulation. Serum LDH and GGT level correlate with tumor burden, the metastatic character of BC and intensity of organtoxicity. The aim of our study is to evaluate the serum level of LDH and GGT in BC patients receiving chemotherapy and correlate these enzyme levels with different stages of BC. A total number of 150 subjects were included in the study, comprising 90 histopathologically confirmed 24 to 76 years aged patients of different breast cancer stages, receiving at least 3 cycles of 5-Fluorouracil, Adriamycin, and Cyclophosphamide (FAC) chemotherapy. Sixty age-matched healthy women were enrolled as controls. Blood samples from each were collected after informed consent and analyzed for serum LDH and GGT levels using standard biochemical methods. Data were analyzed using student's paired-T test, Pearson correlation test and ANOVA. Serum LDH and GGT levels were significantly (p < 0.001) increased in BC patients as compared to control group. When all 4 stages of BC were compared to control group, LDH and GGT activities showed a progressive increase from stage I to IV. The study concludes that serum LDH and GGT may be sensitive, specific and profitable biomarkers in early diagnosis of breast cancer, assessing cancer prognosis and response to treatment.

Significance of Serum Lactate Dehydrogenase as a Prognostic Marker and Outcome Predictor in Patients With Breast Cancer

“…However, a substantial increase in serum LDH activity was seen between stages II and IV [ 33 ]. The present study findings are in accordance with the Basnyat AS et al study, which reported a significant increase in serum LDH levels with worsening disease severity (stage) [ 34 ]. A research study by Agarwal et al, reported higher serum LDH levels in breast cancer patients than in the control group, with a correlation observed in the clinical stage and size of the tumor, which is consistent with the findings of this research study [ 14 ].…”

Study of Efficacy of Serum Lactate Dehydrogenase, Gamma Glutamyl Transpeptidase and Alkaline Phosphatase Levels as Prognostic and Diagnostic Markers in Breast Cancer

“…7). Present study findings are in accordance with the study conducted by Basnyat AS et al 9 Guddanti Rajeswari et al 10 , in their study, observed serum LDH is significantly increased in Ca breast patients when compared to controls. In the study of Aditi Agarwal et al .…”

“…(Fig 3). Present study findings are in accordance with the study Basnyat AS et al 9 , Guddanti Rajeswari et al 10 , Jarari et al 16 Choudhari et al 14 andChandrakanth et al 17-----in their study observed serum GGT levels are significantly increased in Ca breast patients when compared to controls and also observed the further significantly increased levels of GGT (P-value <0.0001) in different stages of Ca breast cases compared to control subjects. In contrast, to present study Guddanti Rajeswari et al 10 , in their study, there is a negative correlation (r-value=-0.2105) of serum GGT with ALP levels in the post-menopausal group of breast cancer patients.…”

Using of lactate dehydrogenase and Gamma glutamyl transpeptidase as routine screening test among patients with breast cancer

“…Our result also supported by some study mentions that level of LDHA is elevated in many malignant tumors and is associated with tumor proliferation and malignant growth, with potential implications for tumor diagnosis and therapy and The high activities of LDH in cancer cells may be due to the process of high cell proliferation, migration, or invasion than normal cells [20]. Our study also study revealed, Gamma glutamyl transpeptidase (GGT) were significantly increased only at grade III (p value 0.022) .These observations were in agreement with the studies of Fentiman, et al [21] and McElroy et al [22]. Other study conducted by Basnyat et al, find that LDH and GGT showed steady and progressive increase in the activities of these enzymes from stage I-IV.…”