Lippert M C, Javadpour N
Cancer. 1981 Nov 15;48(10):2274-8. doi: 10.1002/1097-0142(19811115)48:10<2274::aid-cncr2820481024>3.0.co;2-w.
In a prospective study of 80 patients with germinal testicular cancer, serial determinations of lactic dehydrogenase (LDH), alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) were followed for a mean of 18.1 months. Serum LDH was found to be elevated more frequently with increasing tumor bulk. LDH was elevated in 78.0% of the patients with Stage III disease but only 26.3% of the Stage II patients and 20.0% of the pre-orchiectomy Stage I patients. In this study, serum HCG and AFP levels were always elevated in the presence of elevated serum LDH levels except in one patient when LDH was the only elevated marker, in which case it correlated with clinical disease. Correlation of these three serum markers is shown by elevation of LDH in 78.0% of the Stage III patients, AFP in 78.6%, and HCG in 76.2%. In addition, of the 43 patients who had normal LDH levels on initial presentation, their mean survival time (MST) at the end of the study was 15.5 months while the 26 patients who had elevated LDH levels on initial presentation had an MST of 9.2 months. Serum LDH, therefore, may be useful in evaluating patient prognosis as well as an adjunct in monitoring the treatment of patients with bulky testicular cancer. The combination of LDH and HCG has been utilized to monitor the treatment of seminoma.
在一项对80例原发性睾丸癌患者的前瞻性研究中，对乳酸脱氢酶（LDH）、甲胎蛋白（AFP）和人绒毛膜促性腺激素（HCG）进行了连续测定，平均随访时间为18.1个月。发现血清LDH随肿瘤体积增大而升高的频率更高。在Ⅲ期疾病患者中，78.0%的患者LDH升高，而Ⅱ期患者中只有26.3%，术前Ⅰ期患者中只有20.0%。在本研究中，血清HCG和AFP水平在血清LDH水平升高时总是升高，只有1例患者LDH是唯一升高的标志物，在这种情况下，它与临床疾病相关。这三种血清标志物的相关性表现为：Ⅲ期患者中78.0%的患者LDH升高，78.6%的患者AFP升高，76.2%的患者HCG升高。此外，在最初就诊时LDH水平正常的43例患者中，研究结束时他们的平均生存时间（MST）为15.5个月，而最初就诊时LDH水平升高的26例患者的MST为9.2个月。因此，血清LDH可能有助于评估患者预后，以及作为监测大块型睾丸癌患者治疗的辅助手段。LDH和HCG的联合已被用于监测精原细胞瘤的治疗。
