STUDY OF SERUM LACTATE DEHYDROGENASE LEVELS IN LYMPHOMA PATIENTS IN A TERTIARY CARE HOSPITAL.
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Abstract
Lymphoma is a neoplasm of clonal proliferation of lymphoid cells. It is divided into Hodgkin lymphoma(HL) and non-Hodgkins lymphoma(NHL). HL usually manifests as a nodal disease, usually involving cervical, axillary, and inguinal nodes involving a single group. NHL develops in nodes as well as extra-nodal locations like gastro intestinal tract and oral cavity. [1].
Lactate dehydrogenase (LDH) is an oxidoreductase that aids in interconversion of pyruvate and lactate. LDH has five subtypes which are organ specific. LDH type 2 is mainly found in lymphoid tissues. [3,4]
LDH estimation is a very inexpensive test which can offer evaluation of disease extent in patients with lymphoma. [5, 6] Damage to the cell membrane during high stress related to rapid cell division causes LDH release in to the serum and rise in the level of LDH is seen in various malignancies. [7]
The malignant cells utilize almost as much as five times the glucose compared to normal tissues, converting it into lactate and shunting it into hexose monophosphate shunt. The increased levels of LDH in malignancies may reflect increased production of LDH by cancer cells . LDH is one of the components of Lymphoma International Prognostic Index. LDH serum level is considered a valuable biochemical parameter in the evaluation of disease extension in both HL as well as NHL.[8]
Lymphoma is broadly divided into Hodgkins lymphoma(HL) and Non Hodgkins lymphoma (NHL)categories [9, 10] During the past decades incidence of highly aggressive NHL cases is on the rise. NHL has a good chemosensitivity and early detection and evaluation of disease burden is a key factor in patient treatment and prognosis.
LDH is not a very specific for lymphoma. But it is a good marker for assessing disease activity and cellular proliferation and it can be used as an inexpensive tool for both diagnosis and screening of suspected lymphoma cases. Biopsy is the gold standard for detection of lymphoma. LDH can provide a strong adjunct to clinical and radiological information. [11,12]
References
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Dr. Beshwanth Chowdary V
Assistant Professor, Department of Pathology, Government Medical College (RIMS), Kadapa.
Dr. D. Bhavya
Assistant Professor, Department of Pathology, Government Medical College (RIMS), Kadapa.
Dr. K. Divija
Assistant Professor, Department of Pathology, Government Medical College (RIMS), Kadapa.
Dr. C. Venkata Harish
Assistant Professor, Department of Pathology, Government Medical College (RIMS), Kadapa.