title: Pleural LDH as a prognostic marker in adenocarcinoma lung with malignant pleural effusion.
abstract: To study the performance of serum and pleural lactate dehydrogenase (LDH) level in predicting survival in patients with adenocarcinoma lung presenting with malignant pleural effusions (MPE) at initial diagnosis.Retrospective cohort study of the patient hospitalized for adenocarcinoma lung with MPE in year 2012.Univariate analyses showed lower pleural fluid LDH 667 (313-967) versus 971 (214-3800), P = 0.04, female gender 9 (100%) versus 27 (41.5%), P = 0.009, never smoking status 9 (100%) versus 36 (55.3%), P = 0.009, and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy 8 (89%) versus 26 (40%), P = 0.009 to correlate with survival of more than 1.7 year versus less than 1.7 year. In multivariate analysis, low pleural fluid LDH and female gender maintained significance. The pleural LDH level of ≤1500 and >1500 U/L discriminated significantly (P = 0.009) between survival.High pleural LDH (>1500 IU/L) predicts shorter survival (less than a year) in patients with adenocarcinoma lung presenting with MPE at the time of initial diagnosis. This marker may be clinically applied for selecting therapeutic modality directed at prevention of reaccumulation of MPE. Patients with low pleural LDH may be considered suitable for measures that provide more sustained effect on prevention of reaccumulation such as chemical pleurodesis or tunneled pleural catheter.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Akash
authors.initials: A
authors.lastname: Verma
authors.forename: Chee Kiang
authors.initials: CK
authors.lastname: Phua
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Sim
authors.forename: Reyes Elmer
authors.initials: RE
authors.lastname: Algoso
authors.forename: Kuan Sen
authors.initials: KS
authors.lastname: Tee
authors.forename: Sennen J W
authors.initials: SJ
authors.lastname: Lew
authors.forename: Albert Y H
authors.initials: AY
authors.lastname: Lim
authors.forename: Soon Keng
authors.initials: SK
authors.lastname: Goh
authors.forename: Dessmon Y H
authors.initials: DY
authors.lastname: Tai
authors.forename: Ai Ching
authors.initials: AC
authors.lastname: Kor
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ho
authors.forename: John
authors.initials: J
authors.lastname: Abisheganaden
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology* / Q000401:mortality*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis* / Q000097:blood; D008175:Lung Neoplasms / Q000201:enzymology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000097:blood / Q000201:enzymology*; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase