Monitoring a 'metabolic shift' after surgical resection of oral squamous cell carcinomas by serum lactate dehydrogenase

J Oral Pathol Med. 2016 May;45(5):346-55. doi: 10.1111/jop.12374. Epub 2015 Sep 25.

Abstract

Objectives: Monitoring surgical removal of oral squamous cell carcinomas (OSCC) is being routinely performed through clinical and imaging follow-up. We analyzed the potential use of serum lactate, lactate dehydrogenase (LDH), and LDH isoenzymes (LDH 1-5) as biomarkers in blood for the monitoring of surgical removal of OSCC.

Materials and methods: Serum lactate, LDH, and LDH isoenzymes (LDH 1-5) have been prospectively assessed in healthy individuals (n = 19), patients with OSCC (n = 34: primary OSCC, n = 32 and recurrent OSCC, n = 2) before surgery and after curative tumor resection (n = 26). LDHA and LDHB expressions were analyzed by immunohistochemistry (IHC) in the same OSCC tumor specimen.

Results: Positive LDHA tumor tissue expression measured by IHC (n = 34/34, 100%) was significantly associated with increased serum LDH-5 (n = 24/34, 71%, P = 0.0258) but weak significantly associated with increased total serum LDH (n = 23/34, 68%, P = 0.0592). Positive LDHB tumor tissue expression measured by IHC (n = 25/34, 74%) was significantly associated with increased total serum LDH (P = 0.0172). After surgery, serum LDH and LDH-5 isoenzyme significantly decreased and LDH-1 significantly increased in the aftercare. A significantly inverse correlation of LDHA with LDHB IHC scores was found (P < 0.0001).

Conclusions: The association of LDHA and LDHB measured by IHC with serum LDH indicates that analyzing this enzyme could serve as a favorable 'liquid biopsy' (non-invasive diagnostic tool) for OSCC.

Keywords: biomarker; lactate dehydrogenase isoenzymes; oral squamous cell carcinoma; tumor metabolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / biosynthesis
  • Biomarkers, Tumor / blood
  • Biopsy
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / enzymology*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Head and Neck Neoplasms / blood
  • Head and Neck Neoplasms / enzymology*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Immunohistochemistry
  • Isoenzymes / biosynthesis
  • Isoenzymes / blood
  • L-Lactate Dehydrogenase / biosynthesis
  • L-Lactate Dehydrogenase / blood*
  • Lactic Acid / blood
  • Male
  • Mouth Neoplasms / blood
  • Mouth Neoplasms / enzymology*
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Recurrence, Local / enzymology
  • Neoplasm Recurrence, Local / pathology
  • Squamous Cell Carcinoma of Head and Neck

Substances

  • Biomarkers, Tumor
  • Isoenzymes
  • Lactic Acid
  • L-Lactate Dehydrogenase