Lactate dehydrogenase and creatine kinase as poor prognostic factors in lung cancer: A retrospective observational study.

Lei Liu,Weimin Li,Ying He,Huairong Tang,Ge Ge,Li Zhang,Yihan Zhu,Yan Huang,Lei Li,Ping Zhou,Santosh K Patnaik

doi:10.1371/journal.pone.0182168

Abstract

PurposeCirculating molecules play important roles in lung cancer diagnosis. In addition, plasma lactate dehydrogenase (LDH) and creatine kinase (CK) have been shown to be closely related to tumor progression in breast cancer, prostate cancer, and colonel cancer. However, the relationships between LDH and CK levels with metastasis occurrence and the survival status of lung cancer patients remain unclear.Experimental designA total of 1142 lung cancer patients were enrolled in this study and were separated into negative or positive groups, according to the plasma levels of CK or LDH. Patients in both groups were assessed for clinical characteristics, metastasis occurrence, and survival status. The Cox regression model was then introduced to confirm whether CK and LDH could act as independent factors for predicting a poor prognosis.ResultsThe results indicated that CK had a close relationship with bone (p < 0.05) and lymph node (p < 0.05) metastases. In addition, LDH was strongly related with bone (p < 0.05), adrenal gland (p < 0.05), and lymph node (p < 0.05) metastases. CK and LDH were also correlated with the survival status of the lung cancer patients (all p < 0.001). According to specific histological classification analysis, it was found that CK was closely related to the survival status of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) patients, while LDH was only correlated with that of ADC patients. Cox regression analysis confirmed that CK and LDH could act as independent factors for predicting a poor prognosis in ADC but not SCC patients.ConclusionsFor the first time, our study confirmed the role of CK in metastasis occurrence and the survival status of lung cancer patients. In addition, it also demonstrated that CK and LDH could be used as independent factors to predict a poor prognosis in ADC patients. The identification of CK and LDH will play important roles in lung cancer diagnosis and poor outcome prediction in the future.

Highlights

Lung cancer is one of the most common cancer-related deaths worldwide, accounting for 86,380 male and 71,660 female deaths in the United States in 2015 [1]
According to specific histological classification analysis, it was found that creatine kinase (CK) was closely related to the survival status of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) patients, while lactate dehydrogenase (LDH) was only correlated with that of ADC patients
Cox regression analysis confirmed that CK and LDH could act as independent factors for predicting a poor prognosis in ADC but not SCC patients

Summary

Introduction

Lung cancer is one of the most common cancer-related deaths worldwide, accounting for 86,380 male and 71,660 female deaths in the United States in 2015 [1]. The mortality due to lung cancer in China is 610.2 per 100,000 [2]. The current noninvasive diagnostic methods for lung cancer used in clinical practice include X-ray and computed tomography (CT) scans [5]. The results indicated that the low-dose CT scan group had a 20% reduced mortality compared with the X-ray group, 96.4% of those in the low-dose CT scan group and 94.5% of those in the radiography group who had a positive diagnosis of lung cancer were found to be false positives [6]. In addition to CT and X-ray, other diagnostic methods for lung cancer are invasive, painful, and timeconsuming, such as bronchoscopy and needle biopsy. The discovery of noninvasive, nonradioactive, and rapid diagnostic methods for lung cancer is urgently needed [7]

Methods

Results

Conclusion