Correlation of Salivary Lactate Dehydrogenase in Oral Malignancies

Abstract

INTRODUCTION Diagnostic delays are one of the key reasons behind the poor prognosis and outcomes in oral mailgnancies. The non-invasive technique of saliva collection reduces anxiety and discomfort associated with serum sample collections and simplifies the procurement of repeated samples for longitudinal, long-time monitoring. Progressive increase in Lactate dehydrogenase levels are seen to be positively related to the degree of cellular atypia and can be used as a screening tool in assessing the malignant potential of premalignant lesions. AIMS To study the correlation between increase in salivary Lactate dehydrogenase(LDH) in oral malignant and pre malignant lesions and to study the role of salivary Lactate dehydrogenase as an alternate to conventional biopsy and prognostic tool. MATERIALS AND METHODS All patients with premalignant and proven malignancies were made to give salivary samples before and after surgical intervention. A follow up salivary Lactate dehydrogenase was taken at 6 months, 1 year and 2 year interval for any change in trends and for any rise in levels if recurrences occurred. RESULTS There was a statistically significant (p=0.0001) difference in Lactate dehydrogenase levels pre and post operatively in oral lesions. In cases of recurrence there was a significant rise in LDH levels compared to those without recurrence at similar intervals. CONCLUSION A significantly higher salivary LDH level with a statistically significant fall in the post operative LDH levels(p value= 0.001), This indicates a positive correlation between salivary LDH and presence of dysplastic and malignant cells and can be considered as a non invasive alternative to conventional biopsy with a possible use of salivary LDH as a screening tool to predict recurrence or progression of disease process.