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Objective: To study the diagnostic utility of lactate dehydrogenase levels in differentiating megaloblastic anemia from myelodysplastic anemia in Pakistan. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from Feb, 2019 to Aug, 2019. Methodology: In this study, total 240 patients (18-75 years of age) males and females were selected by consecutive sampling technique and were equally divided into 3 groups; patients with megaloblastic anemia, patients with myelodysplastic syndromes and healthy control group. The clinical history and duration of anemia were recorded on special designed proforma. The laboratory investigations including lactate dehydrogenase levels were also noted. Both types of anemia were compared on basis of Lactate Dehydrogenase Levels. Results: The lactate dehydrogenase levels in megaloblastic group were more than 3000 IU/L in 58 out of 80 patients (72.5%). On other hand, myelodysplastic group had 79 out of 80 patients with lactic acid dehydrogenase levels below 450 IU/L (98.75%). The difference in lactic acid dehydrogenase levels between both groups was found to be statistically significant. Conclusion: Serum lactate dehydrogenase levels can be used to differentiate megaloblastic anemia from other anemia especially myelodysplastic syndromes before doing a bone marrow examination. High lactate dehydrogenase levels above 3000 IU/L in megaloblastic anemia can differentiate it from other anemia.

Background: Breast cancer is the highly prevalent malignancy and is a major killer in women around world. In India, there is substantial statistically significant increase in breast cancer incidence patterns. Women from under developed areas(883000 cases) have a significantly higher no. of cases than those from developed areas (794,000) [1]. There are various risk factors associated with breast malignancy. A variety of bio-chemical markers have been tested to determine the malignancy, for the early detection of carcinoma of different origin. LDH is the easiest and cheapest to calculate of all of these indicators. Objectives: To study the clinical profile of patient with breast To study the prognostic significance of LDH as tumor marker in breast To compare post-operative LDH level in patient undergoing surgery for carcinoma breast v/s patient undergoing neoadjuvant chemotherapy. Compare variation in preoperative baselines LDH levels and post-operative LDH levels. Methodology: It is a prospective observational study done on patients with breast cancer. It will be conducted at Dept. of General Surgery , J.N.M.C and AVBRH, Sawangi (Meghe), Wardha. The study will be conducted on patients with Carcinoma Breast. Results: To be assessed after the study. Conclusion: Serum LDH is a good prognostic marker of breast cancer.

Background The present study aimed to evaluate the prognostic factors in human papillomavirus (HPV)‐positive and HPV‐negative oropharyngeal cancer (OPC) treated with definitive radiotherapy. Methods We retrospectively evaluated 101 patients with OPC who underwent definitive radiotherapy between 2008 and 2018. Results The median follow‐up period of the surviving patients was 68 months (range, 8–164 months). The 5‐year overall survival rate was 69.8%. Univariate analyses revealed that poor survival was associated with male sex, smoking ≥30 pack‐years, Eastern Cooperative Oncology Group performance status ≥1, tumor‐node‐metastasis (TNM) stage III‐IV (8th edition), HPV‐negativity, serum lactate dehydrogenase (LDH) ≥202, C‐reactive protein/albumin ratio ≥0.15, and lymphocyte‐to‐monocyte ratio

Background: Biochemical markers in COVID-19 remain to be defined. We analyzed the usefulness of LDH and ferritin in predicting outcome. Methods: This retrospective study analyzed ferritin and LDH concentrations obtained during the first 11 days of hospitalization in COVID-19 patients. We compared the change in ferritin and LDH concentrations obtained on each day of hospital admission with respect to baseline values between patients with favorable and unfavorable outcomes. We used receiver operating curve analysis to determine cutoffs for predicting outcomes. Results: We analyzed 387 patients. For determinations done on the 9th day, increases in LDH concentrations > 14.6% over the baseline yielded 80% positive predictive value, and a lack of increase yielded 96% negative predictive value for unfavorable outcomes. The change in ferritin concentration yielded lower predictive values. Conclusion: The percentage of change in LDH with respect to the baseline on the 9th day of hospitalization can predict outcome..

BACKGROUND Sepsis is a potentially life threatening medical emergency. It should be diagnosed at the earliest and treated effectively to prevent mortality. Therefore, there is a need for parameters which are simple, reliable and cost effective which help in predicting the prognosis and help in managing the patient with sepsis more efficaciously. METHODS A total of seventy patients, 42 male and 28 female patients, over a period of one year, who fulfilled the inclusion and exclusion criteria was included in the study. In this study various clinical variables and biochemical markers including serum lactate dehydrogenase (LDH) were compared among survivor and non–survivor groups and analysed. RESULTS In this study out of 70 patients, 36 patients [51.4 %] expired. Various clinical variables and biochemical markers including serum LDH [on day 1 & day 3], were compared among survivor and non–survivor groups and analysed. Pulse rate, mean arterial pressure (MAP), total leucocyte count, renal function test (RFT), liver function test (LFT), day 3 LDH levels and requirement of ventilator support showed statistically significant difference among the survivor and non-survivor groups. CONCLUSIONS Despite the recent medical advances, sepsis is a multiorgan disease with significant mortality. Hence, we need simple and effective parameters which are essential in assessing the prognosis and in guiding the treatment protocols. This study focused on simple clinical and biochemical parameters with special reference to LDH, which helped us in predicting the mortality. KEYWORDS Markers, Serum LDH, Sepsis, Survival

Objectives: To determine the predictive value of lactate dehydrogenase (LDH) in diagnosis of septic shock and its association with other prognostic scores in critical pediatric patients. Methods: A cross-sectional study was performed at Children’s Hospital of Cairo University between June 2019 and December 2019. A total of 200 pediatric patients were divided into the septic shock group [100 critically ill patients with septic shock from the pediatric intensive care unit (PICU)] and the control group (100 patients with only sepsis). LDH was determined in the first 24 hours of admission. The sensitivity and specificity of LDH in diagnosis of septic shock were assessed; the levels of related indicators of patients with different etiologies were compared; correlations between LDH, Paediatric Index of Mortality Π, and Pediatric Sequential Organ Failure Assessment (PSOFA) were analyzed. Results: LDH was 512 μL (406.50-663.00) in the septic shock group and was significantly higher than that (190 μL, range 160.00-264.50) in the control group (P

Introduction: Hypertensive disorders of pregnancy are major contributor of maternal and perinatal mortality and morbidity. Several laboratory paramerters like AST, ALT, uric acid, LDH are evaluated to study the seriousness of the disease. Aim of this study was to evaluate the effectiveness of serum lactate dehydrogenase as a prognostic marker in pre eclampsia and eclampsia. Materials and Methods: This study was undertaken in Dept of OBG KIMS Hubli for a period of six months from November 2016 to April 2017. It was a prospective comparative case control study. A total of 130 women were enroled for the study. Out of 130 women, 30 women were considered as controls and they were normotensives. Out of remaining 100 who served as cases, 79 women were cases of preeclampsia and 21 women were cases of eclampsia. Results: Preeclampsia and eclampsia were associated with higher levels of LDH .Adverse maternal and foetal outcome were noted in women with higher LDH values. Conclusion: Increased levels of LDH are associated with severity of the disease and adverse maternal and foetal outcome. So LDH levels can act as a prognostic marker in preeclampsia and eclampsia. Keywords: Eclampsia, Outcome, Pre eclampsia, Prediction, Prognosis, Serum Lactate Dehydrogenase.

WOS:000615631000001 PMID: 33235539 Aim of the study: To investigate the prognostic role of lactate dehydrogenase-to-albumin ratio (LAR) in gastric cancer patients undergoing curative resection. Material and methods: A retrospective study was conducted including resectable gastric cancer patients. According to the time-dependent receiver operating characteristics (ROC) analysis, the optimal threshold for pretreatment LAR was 5.5. The Kaplan-Meier method, Cox regression univariate and multivariate analyses were used to analyze the prognostic factors for disease-free survival and overall survival (OS). Results: The study cohort consisted of 81 patients, mean age was 60.2 ±13.8 (range, 29-87) years and 55 (67.9%) were male. The median OS time was 34.8 and 45 months in patients with LAR ≥ 5.5 (n = 50) and LAR < 5.5 (n = 31), respectively. Kaplan-Meier curves showed that with the increase in LAR there was reduced survival, but it was not statistically significant (p = 0.278). Multivariate analyses revealed that the positive lymph node ratio above 20% was an independent predictor in resectable gastric cancer patients (OR = 6.281, 95% CI: 1.135-34.767, p = 0.035). Conclusions: With the increase in LAR survival in gastric cancer decreased, but it was not statistically significant. Studies involving a large patient series are needed.

Background There is evidence that a high level of serum lactate dehydrogenase (LDH) is associated with poorer overall survival in acute myeloid leukemia (AML), but its link to 60‐day mortality of AML remains unclear. Methods All patients newly diagnosed with AML were included in this cohort study. LDH was measured for the first time after admission. Multivariable logistic regression was used to explore the association between serum LDH and 60‐day mortality. Interaction and stratified analyses were conducted including age, sex, albumin, glucose, myoglobin, and standard chemotherapy. Results Three hundred and seventy‐one patients ≥15 years of age, who were newly diagnosed with AML, were consecutively selected. The total prevalence of 60‐day mortality was 27.2% (101/371), while it was 32.1% (42/131) and higher than in the LDH ≥570U/L compared with the LDH, 60‐day mortality remains a significant problem and physicians have devoted much effort into avoiding it. This study shows serum lactate dehydrogenase (LDH) was independently associated with an increased risk for 60‐day mortality among Chinese patients with AML, especially for those with LDH ≥570U/L.

Objective: We assessed the correlation between lactate dehydrogenase(LDH) to phosphate ratio and the prognosis of microsurgically clipping for ruptured intracranial aneurysm (rIA) in this study, to test the hypothesis that serum LDH to phosphate ratio could be a predictor for the outcome of microsurgically clipping for rIA. Methods: The rIA patients between 2012 and 2018 were retrospectively collected. Age, sex, Hunt-Hess(H-H) grade, Fisher grade, smoking, drink, medical history, aneurysm location, hydrocephalus, laboratory data including serum LDH, phosphate and LDH to phosphate ratio, related complication and the outcomes in 3 months were recorded. Results: A total of 1608 rIA patients in our institution were collected, and 856 patients treated by microsurgical clipping were enrolled. A significantly higher LDH- phosphate ratio on admission was observed in patients with poor outcome at 3 months (median±SD, 200.175±107.290 for mRS 0–2 vs 323.826±219.075 for mRS score 3–6; P Conclusions: LDH to phosphate ratio was a potential biomarker and could predict the unfavorable outcome of microsurgically clipping for rIA in 3 months. However, the detailed mechanism remain unclear and the conclusion needs be further confirmed by large-scale randomized clinical trials.

Serum lactate dehydrogenase (LDH) is a marker of cellular necrosis and is elevated in oral potentially malignant disorders, Oral Submucous Fibrosis (OSMF). Serum LDH levels have been used as a valuable biochemical marker in diagnosis of OSMF. To evaluate and compare the levels of serum LDH and haemoglobin in OSMF with normal healthy individuals. Two mL of venous blood was collected by under aseptic conditions and serum was separated from the normal healthy control subjects (Group 1, n= 22) and the OSMF (clinically and histopathologically confirmed cases) patients (Group 2, n= 22). Quantitative estimation of serum LDH and haemoglobin was performed. Significant rise was observed in the serum LDH levels (518.14 ± 48.62 IU/L) while the mean Hb levels (11.3 ± 1.14) were decreased in patients with OSMF in comparison with normal healthy individuals (LDH: 189.77 ± 28.30 IU/L, Hb: 12.94± 0.98 gm%) (P value < 0.0001, < 0.0001). Serum LDH and Hb estimation would serve as a valuable biochemical marker in the diagnosis of OSMF

BACKGROUND/AIM The aim of the present study was to determine whether serum lactate dehydrogenase (LDH) levels before treatment could predict the disease-specific and event-free survival in adult patients with STS. PATIENTS AND METHODS A total of 142 adult patients with primary STS were reviewed. The average follow-up was 73 months with a minimum 2-year follow-up. RESULTS Age was significantly associated with LDH. Tumor grade, sex, tumor size, tumor depth, CRP levels, Hb levels and albumin levels were not related. LDH levels were not significantly related to the oncological outcome including disease-specific survival and event-free survival in multivariate analysis. CRP levels were significantly related to the oncological outcome including event-free survival. CONCLUSION Elevated LDH levels prior to initial treatment were not found to be a poor prognostic factor of oncological outcome in adult STS, in both the univariate and multivariate analyses. We recommend routine measurement of the CRP levels for predicting oncological outcome.

Introduction: Preeclampsia (PE) is a pregnancy specific disease with multisystem complications. In PE endothelial cell injury leads to alteration of various biochemical parameters. Levels of serum lactate dehydrogenase (LDH) & uric acid are known to be elevated in PE. This study was conducted to correlate these two parameters with severity parameters of PE such as blood pressure & proteinuria and to associate these parameters with severity of PE. Aim: To compare serum LDH and uric acid levels between healthy pregnant and preeclamptic women, and to correlate their levels with severity parameters such as BP & proteinuria. Materials and Methods: This is a case-control study conducted between normotensive pregnant (n=50) and preeclamptic women (27 mild PE & 23 severe PE). Serum uric acid was estimated by Uricase method and LDH by enzymatic method. ANOVA and Pearson’s correlation tests were used to analyse the data. The results are expressed as Mean + SD and P value Results: Serum uric acid (mild 7.53 + 1.35; severe 8.16 + 1.57) and LDH (mild 405.56 + 42.69; severe 735.22 + 108.36) levels were significantly elevated in PE group compared to controls (uric acid 4.53 + 1.30; LDH 227.68 + 58.85). The correlation analysis of LDH with systolic blood pressure (SBP) & proteinuria in severe PE group indicated a positive association. However, when uric acid was correlated, SBP associated negatively and proteinuria correlated positively. Conclusion: LDH can be used as a biochemical marker for severity of PE as its levels correlated with other severity parameters of PE unlike that of serum uric acid. Keywords: Preeclampsia, Lactate dehydrogenase, Uric acid.

Background: In previous study, we found elevated serum total lactate dehydrogenase (LDH) before correction of pectus excavatum and a decrease in total LDH after the deformity correction. In the present study, we analyzed total LDH activity and its isoenzyme patterns to investigate the causes of these laboratory findings in patients with pectus excavatum. Methods: Between March 2014 to December 2018, 85 patients with pectus excavatum who had undergone the Nuss procedure (NP) and bar removal (BR) were included into this study. We analyzed (I) total LDH and its isoenzyme patterns before the correction, (II) relationships of total LDH and its isoenzymes with age at time of NP, sex, severity of pectus excavatum, and pectus morphology types, and (III) post-corrective changes. Results: The mean age of the patients was 13.6 (±6.5) years at the age of NP and the mean interval between NP and BR was 2.2 (±0.42) years. Seventy-one males and 14 females were included. The pectus types included 54 symmetric and 31 asymmetric cases. The mean Haller index before NP and BR were 3.8±1.45 and 2.7±0.4, respectively. The mean of total LDH before NP (pre-correction) and BR (post-correction) were 404.2±80.8 and 369.2±79.3 IU/L, respectively. Before correction, total LDH was significantly higher than normal values, irrespective of age [the young group (

In recent years, some encouraging reports have appeared on assessing the degree of brain damage by estimating serum and cerebrospinal fluid enzymes such as lactate dehydrogenase (LDH). In our study, we included 100 patients with isolated head injury arriving at trauma center, PGIMS Rohtak within 24 hours of injury, studied levels of serum LDH on days 1, 3, and 7 of injury, and concluded that levels have diagnostic as well as prognostic significance.

Background/aim The purpose of this retrospective study was to identify the predictive biomarkers of response to pretreatment for patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab. Materials and methods The subjects were 54 patients treated with nivolumab for mRCC with a clear cell component (mccRCC) between September 2016 and February 2018. We analyzed the impact of serum biomarkers (lactate dehydrogenase [LDH], neutrophil-to-lymphocyte ratio, and C-reactive protein) on patients treated with nivolumab. We adopted the International Metastatic Renal Cell Carcinoma Database Consortium prognostic model using six clinical factors (0=favorable, 1 or 2=intermediate, 3 to 6=poor risk groups, respectively). Results The prognostic risk classification (non-poor vs. poor) and serum LDH levels were correlated with the objective response of nivolumab treatment for mccRCC. Elevated serum LDH levels at baseline were an independent biomarker for progression-free survival (PFS) of mccRCC patients receiving nivolumab [HR=2.268 (95%CI=1.014-5.051), p=0.046]. Notably, high LDH levels were associated with a poorer PFS for patients in the favorable-risk group. Conclusion Serum LDH levels at baseline before nivolumab treatment were associated with the objective response and clinical outcome of nivolumab treatment.

Background: Multiple studies have assessed the prognostic significance of serum lactate dehydrogenase (LDH) in patients with breast cancer, but their results remain controversial. This study aimed to evaluate the prognostic value of LDH in breast cancer by meta-analysis. Methods: Electronic searches for relevant articles were conducted in PubMed, Embase and Web of Science databases. The HR and their 95% CI were used to assess the prognostic value of serum LDH. Stata Statistical Software 12.0 was applied for statistical analysis. Results: A total of 11 studies involving 6,102 patients were subjected to final analysis. Our results showed that higher serum LDH had significant effect on poor overall survival (HR, 1.88; 95% CI, 1.68-2.11) and progression-free survival (HR, 1.98; 95% CI, 1.46-2.68). Moreover, the results of subgroup analyses were consistent with that of overall outcomes. No significant heterogeneity and publication bias were found in this study. Conclusion: Serum LDH could act as a prognostic factor for patients with breast cancer. Future data are needed to validate and update our results.

Background Coronavirus disease 2019 pandemic causes significant strain on healthcare infrastructure and medical resources. So, it becomes crucial to identify reliable predictor biomarkers for COVID-19 disease severity and short term mortality. Many biomarkers are currently investigated for their prognostic role in COVID-19 patients. Our study is retrospective and aims to evaluate role of semi-quantitative CT-severity scoring versus LDH as prognostic biomarkers for COVID-19 disease severity and short-term clinical outcome. Results Two hundred sixty-six patients between April 2020 and November 2020 with positive RT-PCR results underwent non-enhanced CT scan chest in our hospital and were retrospectively evaluated for CT severity scoring and serum LDH level measurement. Data were correlated with clinical disease severity. CT severity score and LDH were significantly higher in severe and critical cases compared to mild cases (P value < 0.001). High predictive significance of CT severity score for COVID-19 disease course noted, with cut-off value ≥ 13 highly predictive of severe disease (96.96% accuracy); cut-off value ≥ 16 highly predictive of critical disease (94.21% accuracy); and cut-off value ≥ 19 highly predictive of short-term mortality (92.56% accuracy). CT severity score has higher sensitivity, specificity, positive, and negative predictive values as well as overall accuracy compared to LDH level in predicting severe, critical cases, and short-term mortality. Conclusion Semi-quantitative CT severity scoring has high predictive significance for COVID-19 disease severity and short-term mortality with higher sensitivity, specificity, and overall accuracy compared to LDH. Our study strongly supports the use of CT severity scoring as a powerful prognostic biomarker for COVID-19 disease severity and short-term clinical outcome to allow triage of need for hospital admission, earlier medical interference, and to effectively prioritize medical resources for cases with high mortality risk for better decision making and clinical outcome.

Background: Organophosphorus compounds have been widely used for a few decades in agriculture for crop protection and pest control. In India Organophosphorus poisoning is the most common. The objective of our study was to measure the LDH Level in acute organophosphorus poisoning Methods: This study was conducted among minimum 100 patients acute organophosphorus poisoning admitted in Casualty ward, MICU and attending medical ward of JLN hospital, Ajmer during Aug 2018 to July 2020. Serum lactate dehydrogenase estimation by spectrophotometric analysis using Beckman Coalter AU 680 Results: These were significantly higher among deaths on day 1 and 3(810±372.99 and 1027.09±458.26, respectively) in comparison to survivors on day 1 and 3 (538.18±300.42 and 365.19±175.49, respectively). Significant difference was found between mean values of different levels of severity of LDH on day 1 and 3. Conclusion: In conclusion, this study found that Serum LDH can be used as biomarker in diagnosis or stratifying severity of acute OP poisoning, as it is cheap and easily available, especially in developing countries. Serial measurements of serum LDH levels in acute OP poisoning can predict the prognosis. Keywords: LDH, OP poisoning, Severity

Xi Wang,1,* Chunbin Wang,2,* Haijun Zhang1 1Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, People’s Republic of China; 2Department of Oncology, Yancheng Third People’s Hospital, The Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng, Jiangsu Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Haijun ZhangDepartment of Oncology, Zhongda Hospital, Medical School of Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, Jiangsu Province, People’s Republic of ChinaTel/Fax +86 25 8327 2216Email zhanghaijunseu@163.comPurpose: 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.Patients and Methods: 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.Results: The LDH level was elevated in 21 (28.77%) patients with PC, 3 (3.33%) PBD patients, and no HPE individuals (P< 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 (P< 0.05).Conclusion: 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.Keywords: pancreatic cancer, lactate dehydrogenase, diagnosis

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of diffuse LBCL. The patient was a 71-year-old female admitted to our hospital with hypoxia. On admission, chest computed tomography revealed a ground-glass opacity. Interstitial pneumonia associated with systemic scleroderma was suspected because of positive anti-centromere antibody. Thereafter, steroid pulse therapy and plasma exchange were performed. Although ground-glass opacity improved, bilateral pleural effusion appeared, so we performed a random skin biopsy because of her elevated serum lactate dehydrogenase and soluble interleukin-2 receptor levels. The patient was diagnosed with IVLBCL with symptoms improving after 6 cycles of rituximab plus chemotherapy treatment.

PURPOSE/OBJECTIVE(S) The present study aimed to evaluate prognostic factors, particularly with respect to their role in establishing distinct prognostic subsets of human papillomavirus (HPV)-positive and -negative oropharyngeal cancer (OPC). MATERIALS/METHODS This study retrospectively evaluated 101 patients with OPC who underwent radiotherapy (RT) alone or chemoradiotherapy (CRT) at our institution between August 2008 and December 2018. Whole neck RT (44.0-50.0 Gy/22-25 fractions) was delivered by intensity-modulated RT (IMRT), followed by boost IMRT to high-risk clinical target volume (total dose of 70.0 Gy/35 fractions). Seventy patients (69.3%) received concurrent chemotherapy. Clinical factors which were potentially associated with prognosis were analyzed. Receiver-operating characteristic curve analysis was adopted to determine the most appropriate cut-off points of hematological biomarkers including the serum lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein/ albumin ratio (CRP/Alb). RESULTS The median follow-up period of the surviving patients was 68 (range; 8-164) months. The 5-year overall survival rate were 69.8%. Univariate analyses revealed that poor survival was associated with gender of male, smoking≥30 pack years, Eastern Cooperative Oncology Group performance status≥1, tumor-node-metastasis (TNM) stage of III-IV (8th edition), HPV-negative, LDH≥202, CRP/Alb≥0.15, LMR < 2.90. In multivariate analyses, poor survival was independently correlated with smoking ≥30 pack years (P < 0.01), LDH ≥202 (P = 0.02). Patients were divided into two groups according to HPV status as HPV-positive and negative OPC and potential prognostic factors were assessed in univariate analyses. In HPV-positive OPC patients, poor survival was significantly associated with smoking ≥30 pack years (P = 0.03), LDH ≥202 (P = 0.04), and LMR < 2.90 (P < 0.01). In HPV-negative OPC patients, gender of male (P < 0.01), smoking ≥30 pack years (P < 0.01), LDH ≥202 (P < 0.01), and CRP/Alb ≥0.15 (P = 0.01) were significant predictors of poor survival. CONCLUSION The present study revealed that high LDH levels predicted poor survival after definitive radiotherapy in both HPV-positive and HPV-negative OPC patients. High LDH levels were stronger poor prognostic factor than HPV status and TNM stage in this study.

This prospective study was conducted among 30 children who had clinically suspected megaloblastic anaemiain a tertiary care hospital. With a purpose to study the role of serum Lactate dehydrogenase (LDH) levelas an early marker and prognostic indicator for megaloblastic anaemia in children. After Children’s wereidentified by taking detailed clinical history and examination were subjected for the various investigation,then LDH level were co-related with the duration of illness, severity of anaemia, and clinical response totreatment. Statistical data was analysed using graph-pad. The commonest age group was between 5-10yrs(n=17, 56.6%), showing male: female ratio (M:F, 1.5:1), 84%were from low socio-economic background.Those children who had longer duration of illness had higher serum LDH level. Serum LDH levels falls inresponsive to the therapy. The study concludes that megaloblastic anaemia is still a common and preventablecause of anaemia in school going children and adolescents. Early recognition of megaloblastic anaemia withsimple investigation like serum LDH level estimation and subsequent effective therapy will have a goodoutcome.

Most human diseases are systems diseases, and systems biomarkers are better fitted for diagnostic, prognostic, and treatment monitoring purposes. To search for systems biomarker candidates, lactate dehydrogenase (LDH), a housekeeping protein expressed in all living cells, was investigated. To this end, we analyzed the serum LDH activities from 172,933 patients with 48 clinically defined diseases and 9528 healthy individuals. Based on the median values, we found that 46 out of 48 diseases, leading by acute myocardial infarction, had significantly increased (p p 0.8) for hepatic encephalopathy and lung fibrosis.

Background There was much evidence suggesting that the serum lactate dehydrogenase (LDH) levels reflect the extent of various pathophysiological processes. However, the current information about dynamic change of LDH in COVID-19 pneumonia has not been well investigated. Methods Study was performed in 87 cases confirmed by COVID-19 infection. The serum LDH levels were determined at diagnosis and follow-up visits. The evaluation of clinical response to therapy was based on chest CT scan. We selected the value of LDH around the data of chest CT scan (− 1 ~ + 1 day). Results At diagnosis, significant differences in LDH levels were found between non-severe and severe group (P

Nasopharyngeal carcinoma (NPC) is a common cancer and is treated primarily by chemotherapy and radiotherapy. However, NPC with synchronous second primary cancer (SSPC) is very rare and its risk factors, treatment and prognosis remain unclear. In this study, we aimed to analyze patients with NPC and SSPC, and attempt to find potential predictors for these patients.We retrospectively collected 681 patients with NPC from 2006 to 2018. Patients in this study were divided into two groups: those patients with SSPC and those without SSPC. We then analyzed the demographic data and survival of these two groups. Independent predictors of SSPC were determined by multivariate regression analysis. A comprehensive review of the literature was also performed.We identified 17 NPC patients with SSPC in our case series and 13 cases in the literatures, and the most common SSPC is lung (16.1%). In univariate analysis, NPC patients with SSPC had older age (P 0.001) and higher serum lactate dehydrogenase (LDH) (P = 0.008), compared with those without SSPC. In multivariate analysis, old age (P = 0.001) and high serum LDH (P = 0.023) remained independent predictors of SSPC, and a predictive equation model was established. NPC patients with SSPC had a significantly lower 5-year disease-specific survival rate compared with patients without SSPC (34.0% vs. 77.6%, P 0.001) CONCLUSION: This study demonstrated that pretreatment age and serum LDH were independent predictors for SSPC in NPC patients. These independent factors can be used for early detection, and better facilitate the design of more appropriate treatment by medical professionals.

We explored the associations between progression-free survival (PFS) after the initiation of PD-1 inhibitor therapy and the clinical parameters in patients with NSCLC. We reviewed the clinical data of patients with NSCLC treated with PD-1 inhibitor. Data of a total of 36 patients, including 16 patients with squamous cell NSCLC and 20 patients with non-squamous cell NSCLC were reviewed. Multivariate analyses identified EGFR status, C-reactive protein (CRP), and PFS following previous therapy as being significantly associated with the PFS after initiation of PD-1 inhibitor therapy in patients with NSCLC. In patients with squamous cell NSCLC, the blood neutrophil/lymphocyte ratio (NLR), serum lactate dehydrogenase (LDH), serum C-reactive protein (CRP), and PFS following previous therapy were identified as being significantly associated with the PFS after initiation of PD-1 inhibitor therapy. However, none of these associations, except for PFS following previous therapy, were found in patients with non-squamous cell NSCLC. NLR, LDH and CRP were associated with the PFS after initiation of PD-1 inhibitor therapy in patients with squamous cell NSCLC, and PFS following previous therapy was the common parameter associated with the PFS after initiation of PD-1 inhibitor therapy in both squamous-cell NSCLC and non-squamous-cell NSCLC patients.

Purpose: Tumour cells produce energy through glycolysis and lactate dehydrogenase (LDH) is a key part of glycolysis. Elevation of serum LDH may indicate poor prognosis in primary duodenum adenocarcinoma. We aim to explore the prognostic significance of LDH in this disease. Methods and materials: Two hundred forty-four patients diagnosed with primary duodenum adenocarcinoma who were treated at the Sun Yat-sen Cancer Center from February 1996 to January 2016 were retrospectively analysed. We collected routine clinical data, including baseline LDH. Patients were classified into a normal LDH group (≤ 245U/L) and higher LDH group (>245U/L). Correlations of the LDH level and other clinicopathological characteristics were explored using the Chi-square test. Prognostic factors for overall survival were identified using univariate and multivariate analyses. Results: Two hundred seven patients (84.9%) had normal LDH levels, while 37 patients (15.1%) had abnormally high LDH levels. Higher LDH levels were significantly associated with more distant metastasis, node metastasis, poor differentiation and TNM stage Ⅲ-Ⅳ (P

Context: Head neck cancer (HNCA) in North-East India accounts for 54.48% cancers at all sites, one of the highest in the country. Increased serum lactate dehydrogenase (LDH) activity is considered as a marker of cellular necrosis while serum alkaline phosphatase (ALP) is recognized as an important marker of induction of tumor cell differentiation. Considering the importance and need of biomarker in HNCA and there being no previous study on tumor markers from this highly prevalent region, we intended to examine the role of serum LDH and ALP in head and neck squamous cell carcinoma (HNSCC) and epithelial precursor lesions (EPLs) and also to find their correlation with the different histological grades of tumor. Materials and Methods: This is a prospective observational study on patients with HNSCC and precancerous lesions attending Department of ENT of a Teaching Hospital. Serum LDH and ALP was measured in HNSCC, EPL and control groups and the results were statistically analyzed and compared using analysis of variance, Pearson correlation coefficient, and sensitivity-specificity analysis. Results: Serum LDH was found to be a significant marker of HNSCC. Total serum LDH level was high in both premalignant and HNSCC cases. There was a significant correlation between serum LDH and grades of HNSCC showing highest levels of expression in moderately differentiated SCC. Elevated serum LDH was also seen in erythroleukoplakia, leukoplakia, and verrucous lesion, but serum ALP levels were not significant. Conclusions: This is the first study from this highly prevalent region of HNCA showing that serum LDH could be regarded as a biomarker for malignant and premalignant conditions of the head and neck.

While metabolic syndrome (MetS) is associated with frailty, the correlation of serum lactate dehydrogenase (sLDH) and frailty with MetS remain uncertain. To investigate the relationship between sLDH and frail components in the US with MetS. A total of 4,066 participants aged 40–90 years were assessed from the database of the third National Health and Nutrition Examination Survey, 1988–1994. The participants were classified into MetS and non-MetS groups. Multivariate logistic regression analysis with four models were performed to assess the odds ratio (OR) of the divided tertiles of sLDH levels with frailty, and frail components including slow walking (SW), weakness, exhaustion, low physical activity (LPA), and low body weight (LBW). Higher sLDH levels were positively associated with frailty in the MetS group (p = 0.024) but not in non-MetS group (p = 0.102). After covariate adjustments, the OR of frailty in the upper two tertiles compared to the lowest tertile and revealed statistical significance (p < 0.05). Frail components of SW, weakness, exhaustion, and LPA were associated with higher sLDH (p < 0.05) except for LBW in MetS and non-MetS groups. The results demonstrated the strong association of higher sLDH levels and frailty among US individuals with MetS.

Background The lung immune prognostic index (LIPI) is a marker that combines the derived neutrophil‐to‐lymphocyte ratio (dNLR) and serum lactate dehydrogenase (LDH) level and is a recently reported prognostic factor of immune checkpoint inhibitor therapy for non‐small cell lung cancer (NSCLC). However, there are no reports regarding the prognostic value of LIPI in small cell lung cancer (SCLC). Methods We retrospectively enrolled 171 patients diagnosed with SCLC and treated at Shinshu University School of Medicine between January 2003 and November 2019. Progression‐free survival (PFS) and overall survival (OS) were compared according to LIPI, and we investigated whether LIPI could be a prognostic factor in SCLC using the Kaplan‐Meier method and univariate and multivariate Cox models. Results The median OS of the LIPI 0 group was significantly longer than that of the LIPI 1 plus 2 group (21.0 vs. 11.6 months, P

Introduction: It is difficult to diagnose birth asphyxia if neonatal records are not available. Serum Lactate Dehydrogenase (LDH) level is an easily accessible tool in most of routine laboratories. Aim: To assess the relation of serum LDH with birth asphyxia in term neonates. Materials and Methods: This was a prospective study, done on 50 asphyxiated newborns (cases) and 50 non asphyxiated term newborns (controls) which were taken from Neonatal Intensive Care Unit (NICU), Department of Paediatrics, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India from November 2017 to September 2019. LDH levels were estimated in 50 non asphyxiated neonates of Cord Blood (CB) at birth and in 50 asphyxiated newborns of CB at birth and at 24 hours of life. Chi-square test, Fischer-exact test and student’s t-test were applied in this study. The Software used to analyse and compute data was SPSS version 20. Results: On comparing the controls and cases, mean LDH of CB was 299.90 U/L vs. 999.04 U/L. Mean LDH level in cases at 24 hours was 1574.72 U/L. LDH (CB) sensitivity was 94% with Confidence Interval (CI) 83.45% to 98.75%, specificity was 90.00% with CI 78.19% to 96.67%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of LDH were estimated as 90.38%, 93.75%, respectively. The LDH (CB) value in mild, moderate and severe asphyxia was 585.33±424.78 U/L, 694.91±444.22 U/L, 1369±672.59 U/L, respectively. The LDH at 24 hours of postnatal life values in mild, moderate, severe asphyxiated newborns were 772.33±108.61 U/L, 1103.69±605.25 U/L, 2457±1019.81 U/L, respectively and it showed a highly significant p-value of

Background: Pathology involving the oral epithelium may alter the level of salivary concentration of LDH. Thus its estimation can be used as a non invasive screening tool for the early detection of OPMDs and also to predict its malignant transformation especially in high risk population. Aims and Objectives: To evaluate the salivary and serum levels of lactate dehydrogenase (LDH) in patients having of oral submucous fibrosis (OSMF) and leukoplakia and compare it with healthy individuals. Materials and Methods: A total of 120 subjects were selected and divided into three groups comprising clinically diagnosed cases of OSMF and leukoplakia and healthy subjects as controls. Unstimulated whole saliva and blood samples were collected under aseptic conditions for biochemical estimation of LDH by Semiautomatic Analyzer using LDH kit utilizing enzymatic UV-Kinetic method. The values obtained were statistically analyzed using the SPSS software version 20.0. P-value < 0.05 was considered significant. Results: The mean salivary LDH level in Group I (OSMF) was 631.67 + 7.67, Group II (Leukoplakia) was 492.28 + 16.17 and Group III (Healthy Control) was 140.62 + 8.87. There was a statistically significant difference between the Serum and salivary LDH levels among the various groups of study population. A positive correlation between salivary LDH and serum LDH level was seen and the regression equation for OSMF and leukoplakia was computed. Conclusion: A significant difference was found between mean salivary LDH Levels and serum LDH levels in patients with leukoplakia, OSMF and health controls. A positive correlation was also established between salivary and serum LDH levels in patients with OSMF and leukoplakia patients making saliva a potent non invasive tool for early prediction and detection of PMOD and its malignant transformation.

e20016 Background: An elevated serum LDH level is an adverse prognostic factor in NDMM. However, this category includes quantitative serum LDH levels that range from just over the upper limit of normal (ULN) to levels that may be 2 or more-fold higher than the ULN. This binary classification of serum LDH level of “normal versus elevated” fails to discriminate between the different disease biology that exists among NDMM patients with elevated serum LDH levels. Thus, we attempted to further stratify NDMM patients by the level of their serum LDH and determine its impact on OS. Methods: The cohort included patients diagnosed with NDMM from the Mayo Clinic, Rochester from 2003 - 2017 who were treated with novel agent induction therapy and had serum LDH levels measured at the time of diagnosis. The serum LDH levels were stratified into three levels: Normal (LDH < 222 U/L), Elevated (LDH 223-444 U/L), and Very Elevated (LDH >444 U/L or >2x upper limit of normal). Survival analysis was performed using the Kaplan-Meier survival analysis and compared via the log-rank method. Results: The cohort consists of 1,196 NDMM patients with a median age of 65 (22 – 95). R-ISS classification and cytogenetic risk were available for 968 and 970 patients respectively. The median serum LDH level was (162 U/L (3- 1260)) and an elevated LDH was present in 199 patients (17%). The median OS for patients with normal (N = 997; 83%), elevated (N = 170; 13%) and very elevated (N = 29; 3%) LDH levels were 76 months, 57 months and 23 months respectively (P < 0.001). The impact of these different levels of LDH on OS by R-ISS stage and cytogenetic risk is shown in the Table. Conclusions: A very small subset of NDMM patients has very elevated LDH levels that confer an exceptionally poor OS irrespective of R-ISS stage and cytogenetic risk. Future studies elucidating their disease biology responsible for such poor OS outcomes are warranted.[Table: see text]

A number of studies have investigated the role of serum lactate dehydrogenase (LDH) levels in patients with Ewing's sarcoma, although these have yielded inconsistent and inconclusive results. Therefore, the present study aimed to systematically review the published studies and conduct a meta-analysis to assess its prognostic value more precisely. Cohort studies assessing the prognostic role of LDH levels in patients with Ewing's sarcoma were included. A pooled hazard ratio (HR) with 95% confidence intervals (CIs) of overall survival (OS) or 5-year disease-free survival (DFS) was used to assess the prognostic role of the levels of serum LDH. Nine studies published between 1980 and 2014, with a total of 1,412 patients with Ewing's sarcoma, were included. Six studies, with a total of 644 patients, used OS as the primary endpoint and four studies, with 795 patients, used 5-year DFS. Overall, the pooled HR evaluating high LDH levels was 2.90 (95% CI: 2.09-4.04) for OS and 2.40 (95% CI: 1.93-2.98) for 5-year DFS. This meta-analysis demonstrates that high levels of serum LDH are associated with lower OS and 5-year DFS rates in patients with Ewing's sarcoma. Therefore, serum LDH levels are an effective biomarker of Ewing's sarcoma prognosis.

The prognostic value of serum lactate dehydrogenase (LDH) has been demonstrated in various solid tumors. We attempted to determine whether serum LDH was predictive of survival in thymic carcinoma after surgical resection.Ninety-five patients with thymic carcinoma treated in our hospital between January 2005 and December 2015 were retrospectively enrolled. Serum LDH was measured before surgery and categorized as low or high relative to the upper limit of normal (ULN) (225 U/L). The relationships of serum LDH level and other clinical variables with survival were estimated by Cox regression and Kaplan-Meier survival analysis.Serum LDH levels were found to be significantly associated with overall survival (OS) and progression-free survival (PFS) of these patients. The 1-, 3-, and 5-year PFS were 76%, 51%, and 38%, and the 1-, 3- and 5-year OS were 97%, 75%, and 46%, respectively. Univariate analysis found that high serum LDH (225 U/L) was associated with both lower OS [hazard ratio (HR) =2.710; 95% confidence interval (CI): 1.363-1.5.391; P=0.004] and PFS (HR =3.365; 95% CI: 1.776-6.374; P0.001). Multivariate analysis found that high serum LDH was associated with lower PFS (HR =2.122; 95% CI: 1.056-4.267; P=0.035). Moreover, high LDH was significantly associated with advanced Masaoka stage (P=0.001).High serum LDH (225 U/L) was an independent predictor of decreased PFS in thymic carcinoma patients. It was also significantly associated with reduced OS, but was not an independent predictor of death in those patients.

The present study aimed to evaluate the prognostic significance of preoperative serum lactate dehydrogenase (SLDH) levels for resected gastric cancer and construct prognostic nomograms for risk prediction. The study cohort consisted of 619 patients with D2-resected gastric cancer. The relationship of SLDH levels with clinicopathological features and clinical outcomes was evaluated. Prognostic nomograms were created using identified prognosticators to predict 3-year overall survival (OS) and 3-year disease-free survival (DFS), and bootstrap validation was performed. High SLDH levels were correlated with old age but not depth of invasion or lymph node metastasis. When assessed as a continuous variable, high SLDH levels were independently associated with poor OS and DFS. Internal validation of the developed nomograms revealed good predictive accuracy (bootstrap-corrected concordance indices: 0.77 and 0.75, respectively for prediction of OS and DFS). The preoperative SLDH levels, an identified unfavorable prognosticator, were incorporated into nomograms along with other clinicopathological features to refine the prediction of clinical outcomes for patients with D2-resected gastric cancer.

Background: Serum LDH level is an useful biomarker for cellular injury which may reflect the severity of preeclampsia and it’s level might be a guideline for the management of patient.Objective: To assess serum LDH level in preeclamptic women.Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College (DMC), Dhaka from January to December 2014. Total 105 pregnant women during third trimester (28-40 weeks) aged 18 to 35 years were selected from the Department of Obstetrics & Gynecology of DMC Hospital, Dhaka for this study. Among them, 35 were mild preeclamptic and 35 were severe preeclamptic women. Age matched 35 normotensive pregnant women were control. Serum LDH level was estimated by continuous spectrophotometric method.Results: In this study, serum LDH level was significantly higher (P200 U/L).Conclusion: From this study, it can be concluded that elevated serum LDH level is associated with severity of preeclampsia.Bangladesh Soc Physiol. 2015, December; 10(2): 71-75

To investigate the prognostic significance of preoperative serum lactate dehydrogenase (LDH) in patients undergoing radical cystectomy for bladder cancer (BCa).A cohort of 263 patients undergoing open or laparoscopic radical cystectomy between 2011 and 2016 was studied. Baseline characteristics, hematological variables, follow-up data were collected. Kaplan-Meier curves and Cox proportional hazard regression model were applied to assess the relationship between LDH and overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS).After a median 34.2 (22.9-45.8) months follow-up, all-cause death, cancer-specific death, and disease recurrence occurred in 66 patients, 50 patients, and 91 patients. The elevation of serum LDH was associated with several unfavorable parameters, including advanced age, continent cutaneous urinary diversion, increased neutrophil-to-lymphocyte ratio, decreased lymphocyte-to-monocyte ratio. Patients with a higher serum LDH (220 U/L) had a worse OS (P0.001), CSS (P0.001) and DFS (P0.001). Multivariate Cox analysis suggested that elevated LDH was an independent predictor for OS (hazard ratio [HR]: 3.113, 95% confidence interval [CI]: 1.524-6.358; P = 0.002), CSS (HR: 4.564, 95% CI: 2.008-10.373; P0.001), DFS (HR: 2.051, 95% CI: 1.125-3.739; P = 0.019). Medical history of diabetes, high pT stage, and positive lymph node also were adverse predictors for oncological outcomes of BCa patients in multivariate analysis.Preoperative serum LDH is an independent prognostic biomarker for OS, CSS, and DFS in patients undergoing radical cystectomy for BCa, which can be incorporated into prognostic models.

Elevated serum lactate dehydrogenase (LDH) was commonly reported in COVID-19 patients. However, the relationship between LDH and the incidence of severe cases has not been characterized in those patients.We retrospectively analyzed the characteristics of patients from a designated isolation medical center for COVID-19 patients diagnosed from February 6 to March 1. Variables accessed within 48 hours on admission were compared between patients with and without the severe disease. Logistic model analyses were performed to examine the prognostic value of LDH for predicting severe disease.52 (28.6%) patients later developed severe disease. Comparing to non-severe cases, severe cases had a higher level of serum LDH (321.85 ±â€Š186.24 vs 647.35 ±â€Š424.26, P