口腔癌患者における血清 LDH 活性値および血清 LDH isozyme に関する臨床的, 実験的研究

Abstract

Studies were made on serum LDH activity and isozyme in 126 patients with various oral diseases (54 patients with oral cancer and 72 patients with various benign oral diseases) and in rabbits with experimental oral cancer by Vx2 carcinoma implantation. Alterations of serum LDH activity and isozyme during therapy in oral diseases and tumor-bearing rabbits were assayed. Serum LDH activity was determined according to Wroblewski and Ladue. And electrophoretic separation of serum LDH isozymes was performed according to Yoshida. The results were summarized as follows. 1. 36 (66.6%) of 54 patients with oral cancer showed an elevation of serum LDH activity, whereas in 13 (18.1%) of 72 patients with benign oral diseases a slight elevation of serum LDH activity was observed. Statistically, the significant difference was ascertained in the value of serum LDH activity among the cancer group, the group of benign oral diseases, and the normal group. As to the serum LDH isozyme, a marked increase in LDH_1, and decrease in LDH_2 were present in the patients with benign oral diseases, whereas patients of oral cancer, a marked increase in LDH_4, LDH_5 and decrease in LDH_2 were present. But on the average, distribution of 5 isozymes was LDH_2>LDH_1>LDH_3>LDH_4>LDH_5 in normal adult individual. 2. Generally, when the activity of serum LDH was compared, its activity in the patients with gingival cancer was relatively higher than that in the patients with upper jaw cancer (from maxillary sinus) or tongue cancer. As to the serum LDH isozyme, no characteristics were observed. 3. A significant difference was found in serum LDH activity and isozyme between patients with upper jaw cancer and patients with chronic maxillary sinuits, and these data seemed to serve as an aid in differential diagnosis. 4. In serum LDH isozyme a marked decrease in LDH_1 and increase in LDH_4, LDH_5 paralleled well to the progressive stages of cancer lesion. But a slight elevation of serum LDH activity was observed. Especially, a significant difference was found in experimental oral cancer 5. On the correlations between serum LDH activity or isozyme and primary lesions in oral cancer, no characteristics were observed. 6. Serum LDH activities in patients with oral cancer undergoing therapy with antitumor agents was markedly decreased in effective group, correlating with tumor regression, whereas ineffective group showed no changes in serum LDH activity. Treatment of these oral cancer with anti-tumor agents resulted in a tendency for normalization of LDH isozyme pattern in effective group ; such was not the case in ineffective group. Especially, serum LDH activity in the patients with effective group was relatively higher than that in the patients with ineffective group undergoing chemotherapy, and experimental oral cancer also showd much the same result. 7. Administration of anti-tumor agents to the experimental animals bearing Vx2 carcinoma by way of intra-arterial infusion with BLM and MMC controlled elevation of serum LDH activity in the effective group. Both an elevation of serum LDH activities and an increase in LDH_4 and LDH_5 were observed in the ineffective group. 8. It is therefor concluded that the changes of serum LDH level following treatment with anti-tumor agents reflect metabolic improvement or aggravation. Determination of serum LDH activity, therefore, may serve as an indicator of the effectiveness of treament by the anti-tumor agents, on the basis of tumor-host-drug relationship.