Wang Xi, Wang Chunbin, Zhang Haijun
Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, People's Republic of China.
Department of Oncology, Yancheng Third People's Hospital, The Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng, Jiangsu Province, People's Republic of China.
Cancer Manag Res. 2021 Jun 21;13:4879-4886. doi: 10.2147/CMAR.S312312. eCollection 2021.
Due to the lack of early-stage detection, pancreatic cancer (PC) remains a devastating disease worldwide. Lactate dehydrogenase (LDH) is associated with tumorigenesis and cancer progression. This study aims to analyze the diagnostic improvements in serum LDH levels combined with other common tumor biomarkers, including carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA), for monitoring PC.
A retrospective analysis was performed on 73 patients with newly diagnosed PC, 90 patients with pancreatic benign diseases (PBD), and 92 people with healthy physical examination (HPE) at Zhongda Hospital, Southeast University from July 2013 to July 2020. The diagnostic efficiencies of serum levels of LDH, CA19-9, and CEA were analyzed through receiver operating characteristic (ROC) curves for PC. The sensitivity and specificity were evaluated at an optimal cutoff. The prognostic impacts of LDH on PC patients were also assessed.
The LDH level was elevated in 21 (28.77%) patients with PC, 3 (3.33%) PBD patients, and no HPE individuals (<0.05). The sensitivities of LDH, CA19-9, and CEA for the diagnosis of PC were 63.0%, 78.1%, and 72.6%, respectively, but the combination of these three markers increased predictive sensitivity significantly to 87.6%. The specificities of LDH, CA19-9, and CEA for the diagnosis of PC were 93.4%, 84.1%, and 73.1%, respectively. The combined specificity reached up to 96.7%. The medium survival time of PC patients with low-level LDH was 21 ± 5.1 months, whereas that of patients with high-level LDH was only 7 ± 0.92 months (<0.05).
The serum LDH level was higher in PC patients than in PBD patients and HPE individuals and was associated with a poor prognosis. The combined assessment of LDH, CEA, and CA19-9 showed higher sensitivity and specificity for the diagnosis of PC.
由于缺乏早期检测手段，胰腺癌（PC）在全球范围内仍然是一种极具毁灭性的疾病。乳酸脱氢酶（LDH）与肿瘤发生和癌症进展相关。本研究旨在分析血清LDH水平与其他常见肿瘤生物标志物（包括糖类抗原19-9（CA19-9）和癌胚抗原（CEA））联合用于监测PC时的诊断改善情况。
对2013年7月至2020年7月在东南大学附属中大医院新诊断的73例PC患者、90例胰腺良性疾病（PBD）患者和92例健康体检（HPE）者进行回顾性分析。通过PC的受试者工作特征（ROC）曲线分析血清LDH、CA19-9和CEA水平的诊断效率。在最佳临界值处评估敏感性和特异性。还评估了LDH对PC患者的预后影响。
PC患者中有21例（28.77%）LDH水平升高，PBD患者中有3例（3.33%）升高，健康体检者中无升高者（<0.05）。LDH、CA19-9和CEA诊断PC的敏感性分别为63.0%、78.1%和72.6%，但这三种标志物联合使用可使预测敏感性显著提高至87.6%。LDH、CA19-9和CEA诊断PC的特异性分别为93.4%、84.1%和73.1%。联合特异性高达96.7%。LDH水平低者的PC患者中位生存时间为21±5.1个月，而LDH水平高者仅为7±0.92个月（<0.05）。
PC患者血清LDH水平高于PBD患者和健康体检者，且与预后不良相关。LDH、CEA和CA19-9联合评估对PC诊断具有更高的敏感性和特异性。
