Discriminant function based on serum analytes differentiates hepatocarcinoma from secondary liver neoplasia

Abstract Hepatocellular carcinoma (HC) is often difficult to distinguish from secondary liver neoplasia (SLN) by physical and imaging diagnostic procedures alone. To this aim we have extended and improved a laboratory approach based on a serum lactate dehydrogenase isoenzyme ratio (LD4:LD5) by adding the carcinoembryonic antigen: alpha-fetoprotein ratio, alkaline phosphatase, and serum iron concentrations to obtain a highly efficient discriminant function. In two successive cohorts, for a total of 102 patients, all histologically diagnosed, with a prevalence of HC vs SLN of 3:1, we correctly classified 96% of cases (100% of SLN cases). Subsequent verification with the jackknife reallocation statistical algorithm confirmed these results. In conclusion, this discriminant function based on simple laboratory assays of a few analytes is an important tool in solving a diagnostic dilemma in cases of liver neoplasia.

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Pre-treatment serum lactate dehydrogenase and alkaline phosphatase as predictors of metastases in extremity osteosarcoma

Journal of Bone Oncology ◽

10.1016/j.jbo.2015.09.002 ◽

2015 ◽

Vol 4 (3) ◽

pp. 80-84 ◽

Cited By ~ 13

Author(s):

Leonard C. Marais ◽

Julia Bertie ◽

Reitze Rodseth ◽

Benn Sartorius ◽

Nando Ferreira

Keyword(s):

Alkaline Phosphatase ◽

Lactate Dehydrogenase ◽

Serum Lactate ◽

Serum Lactate Dehydrogenase ◽

Pre Treatment ◽

Extremity Osteosarcoma

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Serum lactate dehydrogenase isoenzyme 4/5 ratio discriminates between hepatocarcinoma and secondary liver neoplasia

Clinical Chemistry ◽

10.1093/clinchem/37.8.1419 ◽

1991 ◽

Vol 37 (8) ◽

pp. 1419-1423 ◽

Cited By ~ 2

Author(s):

G Castaldo ◽

G Oriani ◽

L Cimino ◽

M Topa ◽

G Budillon ◽

...

Keyword(s):

Differential Diagnosis ◽

Lactate Dehydrogenase ◽

Liver Metastasis ◽

Serum Lactate ◽

Primary Site ◽

The Other ◽

Serum Lactate Dehydrogenase ◽

Cutoff Value ◽

Potential Index ◽

Liver Neoplasia

Abstract Total lactate dehydrogenase (LD; EC 1.1.1.27) and its five isoenzymes were determined in sera from (a) 98 cases of cirrhosis at various stages classified according to Child and Turcotte; (b) 37 cases of hepatocarcinoma (HC) at different stages of the Okuda classification; (c) 17 patients with secondary liver neoplasia (SLN), mainly from an abdominal primary site; and (d) 19 cases of abdominal neoplasia without liver metastasis, in an attempt to contribute to the differential diagnosis between these conditions. LD-4 was enhanced in SLN and LD-5 in HC, thus indicating the LD-4/LD-5 ratio as a potential index with which to differentiate between HC and SLN patients. At a cutoff value of 1.05, 91% of these patients were correctly classified (82% for SLN and 95% for HC). Consequently, this biochemical index appears to be an efficient and rapid indicator to distinguish HC from SLN. On the other hand, the LD isoenzymes are unable to discriminate between HC and cirrhosis or between abdominal neoplasia with and without liver metastases.

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