Takeda Shinako, Kawamura Sadafumi, Tanaka Takaki, Tochigi Tatsuo
Department of Urology Miyagi Cancer Center Natori Miyagi Japan.
IJU Case Rep. 2018 Dec 13;2(1):34-36. doi: 10.1002/iju5.12033. eCollection 2019 Jan.
Granulocyte colony-stimulating factor is often reported to induce increases in lactate dehydrogenase, complicating the evaluation of treatment effects on germ cell tumors.
A 30-year-old patient was diagnosed with left testicular seminoma showing enlarged para-aortic lymph nodes and a retroperitoneal tumor. Serum levels of lactate dehydrogenase were elevated. Three cycles of bleomycin, etoposide, and cisplatin were administered. After chemotherapy, computed tomography showed marked reduction in the metastatic sites. However, serum lactate dehydrogenase levels increased transiently at the end of each course of chemotherapy. In consideration of the residual tumors, one cycle of another chemotherapy was added. Five months after final chemotherapy, lactate dehydrogenase remained within normal limits with no evidence of tumor recurrence.
In our case, transient elevation of lactate dehydrogenase was considered relevant to granulocyte colony-stimulating factor use. Examination of lactate dehydrogenase isoenzymes may be helpful to estimate the cause of serum lactate dehydrogenase elevation.
粒细胞集落刺激因子常被报道可导致乳酸脱氢酶升高，这使得评估其对生殖细胞肿瘤的治疗效果变得复杂。
一名30岁患者被诊断为左侧睾丸精原细胞瘤，伴有主动脉旁淋巴结肿大和腹膜后肿瘤。血清乳酸脱氢酶水平升高。给予了三个周期的博来霉素、依托泊苷和顺铂治疗。化疗后，计算机断层扫描显示转移部位明显缩小。然而，在每个化疗疗程结束时，血清乳酸脱氢酶水平短暂升高。考虑到残留肿瘤，又增加了一个周期的另一种化疗。最终化疗五个月后，乳酸脱氢酶仍在正常范围内，无肿瘤复发迹象。
在我们的病例中，乳酸脱氢酶的短暂升高被认为与使用粒细胞集落刺激因子有关。检测乳酸脱氢酶同工酶可能有助于评估血清乳酸脱氢酶升高的原因。
