MEASUREMENT OF LACTATE LEVELS IN SERUM AND BILE USING PROTON NUCLEAR-MAGNETIC-RESONANCE IN PATIENTS WITH HEPATOBILIARY DISEASES - ITS UTILITY IN DETECTION OF MALIGNANCIES

Proton nuclear magnetic resonance (H-1-NMR) has been utilized for qual itative and quantitative measurement of the components of nonhomogeneo us biological specimens, as it can analyze sensitively the chemical st ructure of organic compounds without pretreatment of the materials, Le vels of lactate in serum and bile were measured by H-1-NMR in healthy volunteers and patients with non-malignant or malignant diseases of th e liver and biliary tract, and the usefulness of such measurements for the diagnosis of hepatobiliary malignancies was determined. The mean (+/-SD) serum lactate levels were 0.52 +/- 0.33 mmol/l in five healthy volunteers, 1.38 +/- 1.59 mmol/l in 30 patients with non-malignant di seases and 2.95 +/- 2.00 mmol/l in 21 patients with malignant diseases , the differences among the three groups being significant, Biochemica l enzymatic measurement of serum lactate levels revealed no such diffe rence, In bile, the spectrum of lactate was observed in all of 16 pati ents with malignant diseases, but in none of two healthy volunteers an d 12 patients with non-malignant diseases. The mean time required for the measurement was 36.77 min for serum and 6.40 min for bile, The mea surement of lactate levels in serum and bile using H-1-NMR may be usef ul for the detection of hepatobiliary malignancies.