Gastric-juice enzymes--an aid in the diagnosis of gastric cancer?

Lactic dehydrogenase (LDH) and beta-glucuronidase concentrations were measured in the resting gastric juice of 113 patients presenting with dyspepsia. All patients were investigated by double-contrast barium meal, endoscopy with biopsy, and, when appropriate, by laparotomy. In all patients tested there was a positive correlation between LDH and beta-glucuronidase concentrations. An index derived from the two enzyme activities correctly predicted the presence of gastric carcinoma in 41 out of 42 cases, and identified the only 2 cases of early gastric cancer in the series. There were 13 (11.5%) false-positive results, all in cases with extensive intestinal metaplasia, a change which may be associated with an increased risk of gastric malignancy. The measurement of gastric-juice enzymes is useful in the diagnosis of gastric cancer and may be of value in the identification of high-risk groups. The test is easily performed, inexpensive, and reproducible.