Tuberc Respir Dis.  1990 Mar;37(1):45-51. 10.4046/trd.1990.37.1.45.

LDH Isoenzyme Pattern in Malignant Pleural Effusion

• KMID: 2528510
• DOI: http://doi.org/10.4046/trd.1990.37.1.45

Abstract

It is well known that elevation of LDHl and LDH2 isoenzyme is found in one third of malignant pleural effusion. It was speculated that above characteristic pattern may be related to mechanisms of malignant effusion, that is, whether the tumor invades pleura directly or not. To evaluate the mechanism of malignant pleural effusion we compared LDH isoenzyme patterns with the presence of direct invasion to pleura. The results are summarized as follows; 1) Among 35 cases of malignant effusions, 23 cases showed direct pleural invasion, and 12 cases did not reveal direct invasion. 2) The proportion of LDH₁and LDH₂ predominant pattern were 13% and those of LDH₄ and LDH₅ predominant pattern were 87% among direct pleural invasion group. 3) Among 12 cases of not-invaded group, 33% showed LDH, and LDH, predominant pattern and 67% showed LDH, and LDH5 predominant pattern. 4) Not-invaded group showed more LDH₁ and LDH₂ predominant, transudate-like patterns than invaded group. 5) All of nine cases of benign exudative effusions showed LDH₄ and LDH₅ predominant pattern. 6) Fractions of LDH isoenzymes for direct pleural invasion group were LDH₁ 12.4± 6.8%, LDH₂ 19.5± 7.9%, LDH₃22.0± 5.8%, LDH₄ 21. 5± 7.4%, end LDH₅ 25.6 ± 14 .2%, and those of not-invaded g roup were LDH₁ 17 .7 ± 8.7% , LDH₂ 26.8 ± 7.1%, LDH₃ 22.9± 3.6% , LDH₄ 17 .2 ± 6.0% and LDH₅ 15. 5± 8. 1 %. Decrease of LDH₂and increase of LDH₅ of direct pleural invasion group for not-invaded group we re statistically significant. We suggested that LDH₁ and LDH₂ predominant pattern of LDH isoenzyme fractions in exudative pleural effusion is most likely malignant if pleural effusions were negative for cytology and pleural biopsy. and also suggest that above phenomenon ma y be related with the direct invasion of pleura by malignancy