Endocrinol Metab.  2021 Feb;36(1):96-105. 10.3803/EnM.2020.819.

Lactate Dehydrogenase A as a Potential New Biomarker for Thyroid Cancer

Affiliations
  • 1Department of Surgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
  • 2Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, Korea
  • 3Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 5Department of Biochemistry and Molecular Biology, Yonsei University College of Medicine, Seoul, Korea

Abstract

Background
Several cancers show increased levels of lactate dehydrogenase A (LDHA), which are associated with cancer progression. However, it remains unclear whether LDHA levels are associated with papillary thyroid cancer (PTC) aggressiveness or with the presence of the PTC prognostic marker, the BRAFV600E mutation. This study aimed to evaluate the potential of LDHA as a PTC prognostic marker.
Methods
LDHA expression was examined in 83 PTC tissue specimens by immunohistochemistry. Human thyroid cell lines were genetically manipulated to overexpress BRAFV600E or were treated with a BRAF-specific short hairpin RNA (shBRAF), whose effects on LDHA expression were evaluated by Western blotting. Data from 465 PTC patients were obtained from The Cancer Genome Atlas (TCGA) database and analyzed to validate the in vitro results.
Results
LDHA was aberrantly overexpressed in PTC. Intense immunostaining for LDHA was observed in PTC specimens carrying mutated BRAF, whereas the intensity was less in wild-type BRAF samples. Overexpression of BRAFV600E resulted in LDHA upregulation, whereas treatment with shBRAF downregulated LDHA in human thyroid cell lines. Furthermore, LDHA mRNA expression was significantly elevated and associated with BRAFV600E expression in thyroid cancer tissues from TCGA database. Additionally, LDHA overexpression was found to be correlated with aggressive clinical features of PTC, such as lymph node metastases and advanced tumor stages.
Conclusion
LDHA overexpression is associated with the BRAFV600E mutation and an aggressive PTC behavior. Therefore, LDHA may serve as a biomarker and therapeutic target in PTC.

Keyword

Biomarkers; BRAF; Lactate dehydrogenase A; Thyroid cancer, papillary; Prognosis
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