alexa Serum and Tissue LDH Levels in Patients with Breast Gynaecological Cancer and Benign Diseases


Journal of Womens Health Care

Author(s): Koukourakis MI, Kontomanolis E, Giatromanolaki A, Sivridis E, Liberis V

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Background: Lactate dehydrogenase A (LDHA) is involved in anaerobic glycolysis. In cancer patients, serum total lactate dehydrogenase (LDH) levels are often increased, and the gene for one of its isoenzymes, LDHA, is up-regulated. These features have been linked to poor prognosis in several studies. Methods: We investigated comparatively the total serum LDH activity and tissue isoenzyme LDH5 and hypoxia-inducible factor 1α (HIF1α) levels in patients with breast (n = 18) and gynaecological (n = 23) malignancies and benign diseases (n =54). Results: The serum LDH levels were significantly higher in patients with endometrial adenocarcinoma (349 ± 100 IU/l) and ovarian cystadenocarcinomas (383 ± 116 IU/l) compared to healthy controls (256 ± 68 IU/l) (p values 0.01 and 0.006, respectively). This difference did not reach significance in patients with breast cancer (328 ± 169 IU/l; p = 0.17)). Uterine leiomyoma patients showed intermediate LDH levels (310 ± 81 IU/l), while patients with breast fibroadenomas and ovarian cystadenomas had LDH serum levels close to carcinomas (308 ± 60 and 348 ± 135 IU/l, respectively). LDH5 isoenzyme was strongly expressed in cancer cells, exhibiting a mixed cytoplasmic/nuclear subcellular pattern. Interestingly, a high LDH5 content in tissue sections was not invariably accompanied by high LDH serum levels. High HIF1α tissue expression was linked to high tissue LDH5 expression. Conclusion: Serum and tissue LDH is up-regulated in gynaecologic and breast malignancies and in a subset of benign conditions such as fibro- and cystadenomas. The release of LDH, however, in the bloodstream is partly related to the LDHA gene up-regulation.

This article was published in Gynecologic and Obstetric Investigationq and referenced in Journal of Womens Health Care

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