The use of the major anoxic stress response protein P34, the K isozyme of lactate dehydrogenase, and carcinoembryonic antigen in the follow-up of patients with colorectal adenocarcinoma.
BACKGROUND
This prospective study evaluated the use of the K isozyme of lactate dehydrogenase (LDH-K) as a complementary tumor marker to carcinoembryonic antigen (CEA) in patients with colorectal adenocarcinoma.


METHODS
In this series, 355 patients underwent potentially curative surgery for primary colorectal adenocarcinoma. A close surveillance program of follow-up revealed 108 patients (30%) who had a serum elevation in CEA and/or LDH-K.


RESULTS
The patients were divided into three groups. Group 1 consisted of 43 patients with elevations in CEA alone. Twenty-seven of 43 patients (63%) had tumor at exploratory laparotomy; and 16 patients (37%) had no evidence of disease after a median follow-up of 74 months. Group 2 consisted of 33 patients with a serum elevation of LDH-K alone. In this group, 5 of 33 patients (15%) had recurrent disease with true elevations of LDH-K. In 28 patients (85%), there were falsely elevated levels of LDH-K with no evidence of disease. Group 3 consisted of 32 patients with elevations of both serum LDH-K and CEA. In this group, 17 of 32 patients (53%) had true elevations of CEA and LDH-K with tumor recurrence, and 15 patients (47%) had false elevations with no evidence of disease.


CONCLUSIONS
LDH-K did not complement CEA as a tumor marker for detecting recurrence in this group of patients with colorectal cancer.
Petrelli
N J
NJ
Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263.
Hanna
S
S
Rodriguez-Bigas
M
M
Anderson
G
G
D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase