Preoperative serum lactate dehydrogenase level predicts progression and prognosis in patients with glioma,Clinical Neurology and Neurosurgery

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Preoperative serum lactate dehydrogenase level predicts progression and prognosis in patients with glioma
Clinical Neurology and Neurosurgery ( IF 1.8 ) Pub Date : 2021-08-30 , DOI: 10.1016/j.clineuro.2021.106912
Xiao-Yong Chen ₁ , Jin-Yuan Chen ₂ , Yue Chen ₁ , Jia-Fang Chen ₃ , Ni Lin ₄ , Chen-Yu Ding ₅ , De-Zhi Kang ₆ , Deng-Liang Wang ₁ , Wen-Hua Fang ₁

Affiliation

Background

To evaluate the value of serum Lactate Dehydrogenase (LDH) level in predicting recurrence and the overall survival (OS) of glioma patients.

Materials and methods

A total number of 216 patients with glioma in our institution were retrospectively recruited to analyze the relationship between preoperative serum LDH level and prognosis.

Results

Overall, the median age of patients was 46.0 (31.0–57.0) years old; 53.7% (116 of 216) of the enrolled patients were male. Multivariate analysis revealed that serum LDH level (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.96–0.98, P < 0.001) and World Health Organization (WHO) grade (grade II: OR = 19.64, 95%CI = 5.56–69.35, P < 0.001; grade III: OR =1 9.50, 95%CI = 7.08–53.73, P < 0.001; grade IV: OR = 15.23, 95%CI = 4.94–46.97, P < 0.001) were significant and independent of 1-year Progression-free survival (PFS) after adjusting for confounders. The predictive performance of serum LDH level was represented with area under curve (AUC) = 0.741, 95%CI = 0.677–0.798. Multivariate Cox analysis revealed that LDH level (hazard ratio [HR] = 2.56, 95%CI = 1.59–4.15, P < 0.001) and WHO grade (grade II: HR = 4.58, 95%CI = 0.56–37.23, P = 0.155; grade III: HR = 16.35, 95%CI = 2.16–123.80, P = 0.007; grade IV: HR = 42.13, 95%CI = 5.83–304.47, P < 0.001) remained associated with survival at 2-year follow-up. At 3-year follow-up, lymphocyte count (HR = 0.68, 95%CI = 0.51–0.91, P = 0.008), LDH level (HR = 2.21, 95%CI = 1.40–3.49, P = 0.001), and WHO grade (grade II: HR = 1.44, 95%CI = 0.44–4.68, P = 0.543; grade III: HR = 4.99, 95%CI = 1.68–14.87, P = 0.004; grade IV: HR = 16.96, 95%CI = 6.13–46.93, P < 0.001) remained associated with survival in multivariate Cox analysis.

Conclusion

Our study demonstrated that preoperative serum LDH level could serve as a reliable indicator for predicting prognosis of glioma patients. Further multicenter studies are still required to verify our findings.

中文翻译：

术前血清乳酸脱氢酶水平可预测胶质瘤患者的进展和预后

背景

评价血清乳酸脱氢酶（LDH）水平在预测胶质瘤患者复发和总生存期（OS）中的价值。

材料和方法

回顾性招募我院216例胶质瘤患者，分析术前血清LDH水平与预后的关系。

结果

总体而言，患者的中位年龄为 46.0（31.0-57.0）岁；53.7%（216 人中的 116 人）为男性。多变量分析显示血清 LDH 水平（优势比 [OR] = 0.97, 95% 置信区间 [CI] = 0.96–0.98, P < 0.001）和世界卫生组织（WHO）分级（II 级：OR = 19.64, 95% CI = 5.56–69.35，P < 0.001；III 级：OR = 1 9.50，95%CI = 7.08–53.73，P < 0.001；IV 级：OR = 15.23，95%CI = 4.94–46.97，P < 0.001) 在调整混杂因素后显着且独立于 1 年无进展生存期 (PFS)。血清 LDH 水平的预测性能以曲线下面积 (AUC) = 0.741, 95%CI = 0.677–0.798 表示。多变量 Cox 分析显示 LDH 水平（风险比 [HR] = 2.56, 95%CI = 1.59–4.15, P < 0.001）和 WHO 等级（II 级：HR = 4.58, 95%CI = 0.56–37.23, P = 0.155 ; III 级：HR = 16.35, 95%CI = 2.16–123.80, P = 0.007；IV 级：HR = 42.13, 95%CI = 5.83–304.47, P < 0.001）在 2 年随访时仍与生存率相关. 3 年随访时，淋巴细胞计数 (HR = 0.68, 95%CI = 0.51–0.91, P = 0.008), LDH 水平 (HR = 2.21, 95%CI = 1.40–3.49, P = 0.001）和 WHO 分级（II 级：HR = 1.44, 95%CI = 0.44–4.68, P = 0.543；III 级：HR = 4.99, 95%CI = 1.68–14.87, P = 0.004；IV 级：HR = 16.96, 95%CI = 6.13–46.93, P < 0.001）在多变量 Cox 分析中仍然与生存相关。