Vergnon J M, Guidollet J, Gateau O, Ripoll J P, Collet P, Louisot P, Brune J
Cancer. 1984 Aug 1;54(3):507-11. doi: 10.1002/1097-0142(19840801)54:3<507::aid-cncr2820540320>3.0.co;2-4.
The relative value of each lactic dehydrogenase isoenzyme (iso LDH) was measured by electrophoretic separation in the serum and the pleural fluid of 100 patients. In each case, the cause of the pleural effusion was known. Two types of LDH isoenzyme pattern were found in the serum: a normal type with a low value of LDH 5 and an abnormal type with a high value of LDH 5. This high LDH-5 level is due to an impaired liver function. In the pleural fluid, the electrophoretic patterns of five LDH isoenzymes were found by computerized processing. During congestive heart failure (28 cases) the electrophoretic pattern of the LDH isoenzymes was always similar in the serum and in the pleural fluid (transudative pleural effusion). During thoracic empyema, the relative values of the isoenzymes in the pleural fluid were regularly increasing from LDH 1 to LDH 5. In this situation, the evaluation of LDH 5 appeared to emanate from the increased granulocytes in the pleural fluid. In 22 inflammatory pleural effusions, the relative values of the five isoenzymes were equal. During malignant effusions (35 cases) a high level of LDH 5 was found in 21 patients. LDH 5 is known to be secreted by malignant tissue, and the authors confirmed it by finding a high level of LDH 5 in biopsy specimens of patients with mesothelioma or epidermoid lung cancer (7 cases). Conversely, the level of LDH 5 was low in biopsy specimens from normal lung tissue or benign inflammatory pleuritis (6 cases). Among the 14 patients with low levels of LDH 5 in the pleural fluid during malignant pleural effusion, the authors found the malignant lymphomas (three cases) and the small cell lung carcinoma (five cases). In these cases, the low level of LDH 5 was in agreement with the result of a low level of LDH 5 found in the biopsy of a metastatic liver localization of a small cell lung carcinoma. So the electrophoretic determination of LDH isoenzymes pattern in pleural fluid is a sensitive tool for the management of pleural effusion.
通过电泳分离法测定了100例患者血清和胸液中各乳酸脱氢酶同工酶（同工LDH）的相对值。每种情况下，胸腔积液的病因均已知。血清中发现了两种类型的LDH同工酶模式：LDH 5值较低的正常型和LDH 5值较高的异常型。这种高LDH-5水平是由于肝功能受损所致。在胸液中，通过计算机处理发现了五种LDH同工酶的电泳模式。在充血性心力衰竭（28例）期间，血清和胸液中（漏出性胸腔积液）LDH同工酶的电泳模式始终相似。在脓胸期间，胸液中同工酶的相对值从LDH 1到LDH 5呈规律性增加。在这种情况下，LDH 5的升高似乎源于胸液中粒细胞的增加。在22例炎性胸腔积液中，五种同工酶的相对值相等。在恶性胸腔积液（35例）中，21例患者的LDH 5水平较高。已知LDH 5由恶性组织分泌，作者通过在间皮瘤或肺鳞状细胞癌患者（7例）的活检标本中发现高LDH 5水平证实了这一点。相反，正常肺组织或良性炎性胸膜炎的活检标本（6例）中LDH 5水平较低。在恶性胸腔积液期间胸液中LDH 5水平较低的14例患者中，作者发现了恶性淋巴瘤（3例）和小细胞肺癌（5例）。在这些病例中，LDH 5水平较低与小细胞肺癌肝转移活检中LDH 5水平较低的结果一致。因此，胸液中LDH同工酶模式的电泳测定是管理胸腔积液的一种敏感工具。
