Rotenberg Z, Weinberger I, Davidson E, Fuchs J, Harell D, Agmon J
Department of Medicine A, Israel and Ione Massada Center for Heart Disease, Petah Tikva, Israel.
Clin Chem. 1989 May;35(5):871-3.
Total lactate dehydrogenase (LD, EC 1.1.1.27) and LD isoenzymes were determined in serum of 170 patients with metastatic liver disease, 35 of whom had multiple metastatic sites. Overall, values of LD were above normal for 78% of the 170 patients. Half of the patients had an isomorphic pattern of LD isoenzymes (i.e., relative increase in all five isoenzymes); the other half had an increased LD-4,5 pattern, mostly a solitary increase in LD-5 only. Of those patients with normal LD values, 92% had the increased LD-4,5 pattern, whereas 70% of patients with LD values greater than 350 U/L had an isomorphic pattern of LD isoenzymes. All 35 patients with multiple metastatic sites had LD activity greater than 350 U/L; in the majority of them (74%) it was greater than 500 U/L; in 31 (89%), the increase was isomorphic. The diagnostic efficiency of the combined LD greater than 225 U/L (upper limit of normal) and increased LD-4,5 test results was much better than that of LD greater than 225 U/L alone (93% vs 74%). We conclude that serum LD and LD isoenzymes should be determined in every patient with suspected liver metastatic disease. The isomorphic pattern of LD isoenzymes is apparently associated with higher values for total LD and was common among the patients with multiple metastatic sites.
对170例转移性肝病患者的血清进行了总乳酸脱氢酶（LD，EC 1.1.1.27）和LD同工酶检测，其中35例有多个转移部位。总体而言，170例患者中有78%的LD值高于正常。一半的患者LD同工酶呈同型模式（即所有五种同工酶相对增加）；另一半患者LD-4、5模式增加，大多仅LD-5单独增加。在LD值正常的患者中，92%有LD-4、5模式增加，而LD值大于350 U/L的患者中有70%有LD同工酶同型模式。所有35例有多个转移部位的患者LD活性均大于350 U/L；其中大多数（74%）大于500 U/L；31例（89%）增加呈同型。LD大于225 U/L（正常上限）和LD-4、5检测结果增加联合使用的诊断效率远高于单独使用LD大于225 U/L（93%对74%）。我们得出结论，对于每例疑似肝转移疾病的患者都应检测血清LD和LD同工酶。LD同工酶的同型模式显然与总LD的较高值相关，且在有多个转移部位的患者中很常见。
