Tuberc Respir Dis > Volume 37(1); 1990 > Article
Tuberculosis and Respiratory Diseases 1990;37(1):45-51.
DOI:    Published online March 1, 1990.
LDH Isoenzyme Pattern in Malignant Pleural Effusion
Hyeon Tae Kim, Choon Taek Lee, O Jung Kwon, In Gyu Hyun, Sung Koo Han, Young Soo Shim, Keun Youl Kim, Yong Chol Han
Department of Internal Medicine, and Tuberculosis Research Institute, College of Medicine, Seoul National University , Seoul, Korea
악성 늑막삼출에서 LDH Isoenzyme 분절에 관한 고찰
김현태, 이춘택, 권오정, 현인규, 한성구, 심영수, 김건열, 한용철
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

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