Preoperative Serum Lactate Dehydrogenase Level Predicts The Prognosis Of Patients With Glioma

Objective: To evaluate the value of serum Lactate Dehydrogenase(LDH)level in predicting recurrence and the overall survival(OS)of glioma patients.Methods: A retrospective analysis was made of 216 patients in our hospital from January2016 to January 2019,who met the inclusion and exclusion criteria.Progression-free survival was defined from the time of surgery to the time of radiological evidence of tumour recurrence.Recurrence group was defined as the evidence of residual tumor volume enlargement or the appearance of a new lesions,whereas patients without these lensions were included in the non-recurrence group.General clinical data of all the study subjects such as age,sex,past medical history,KPS score,white blood cell count,neutrophil count,lymphocyte count,neutrophil count/lymphocyte count,lymphocyte-tomonocyte ratio,serum potassium,serum natrium,serum LDH,serum glucose,World Health Organization grading,were collected and recorded.Statistical analysis of these factors was used to predict the clinical value of progression-free survival of glioma,and the correlation between these clinical indicators and prognosis was observed.Results: Results: Overall,the average age of patients was 43.58±17.22 years old;53.7%(116 of 216)of the enrolled patients were male.These were classified into a recurrence group(n=77,35.60%)and non-recurrence group(n=139,66.40%).The 1-year progression-free survival rate was 64.35%.Multivariate analysis revealed that serum LDH level(odds ratio [OR]=0.97,95(4)confidence interval [CI]=0.95-0.98,P(27)0.001)and World Health Organization(WHO)grade(grade II: OR=24.22,95(4)CI=5.95-98.58,P(27)0.001;grade III: OR=39.81,95(4)CI=10.62-149.25,P(27)0.001;grade IV: OR=28.82,95(4)CI=6.22-133.61,P(27)0.001)were significant and independent of 1-year Progressionfree survival(PFS)after adjusting for confounders.The predictive performance of serum LDH level was represented with area under curve(AUC)= 0.741,95(4)CI=0.668-0.813.Multivariate Cox analysis revealed that LDH level(hazard ratio[HR]=2.56,95(4)CI=1.59-4.15,P(27)0.001)and WHO grade(grade II: HR=4.58,95(4)CI=0.56-37.23,P=0.155;grade III: HR=16.35,95(4)CI=2.16-123.80,P=0.007;grade IV: HR=42.13,95(4)CI=5.83-304.47,P(27)0.001)remained associated with survival at 2-year follow-up.At 3-year follow-up,lymphocyte count(HR=0.07,95(4)CI=0.51-0.91,P=0.008),LDH level(HR=2.21,95(4)CI=1.40-3.49,P=0.001),and WHO grade(grade II: HR=1.44,95(4)CI=0.44-4.68,P=0.543;grade III: HR=4.99,95(4)CI=1.68-14.87,P=0.004;grade IV: HR=16.96,95(4)CI=6.13-46.93,P(27)0.001)remained associated with survival in multivariate Cox analysis.Conclusion: The study demonstrated that preoperative serum LDH level could serve as a reliable indicator for predicting prognosis of glioma patients.Abnormally elevated LDH level may suggest rapid proliferation and progression in glioma cells.Further multicenter studies are still required to verify the findings.