High lactate levels predict likelihood of metastases, tumor recurrence, and restricted patient survival in human cervical cancers

Pathophysiological parameters such as vascular density and tissue oxygen pr essure can influence tumor malignancy and patient survival. Observations fr om our group showed that metastatic spread of carcinomas of the uterine cer vix and of head and neck cancers was closely correlated with the lactate co ncentration in the primary Lesion, Because these results were obtained in a low number of patients, the present investigation was performed to verify such a correlation in a larger population. Cryobiopsies were taken at first diagnosis of cervical cancer from 34 patients, Tissue concentrations of AT P, glucose, and lactate in viable tumor regions of these biopsies were meas ured microscopically using the technique of imaging bioluminescence, There was no correlation between stage or grade and any of the metabolic paramete rs measured, ATP and glucose concentrations were not significantly differen t in metastatic and nonmetastatic primary tumors (P > 0.05), However, lacta te concentrations were significantly higher (P = 0.001) in tumors with meta static spread (mean +/- SD, 10.0 +/- 2.9 mu mol/g; n = 20) compared with ma lignancies in patients without metastases (6.3 +/- 2.8 mu mol/g; n = 14), T he majority of patients who suffered a recurrence of the disease (17 of a t otal of 22 patients) or died (15 of 20) within the observation period of up to 8 years belonged to the metastatic, i.e., high lactate group. A Kaplan- Meier analysis of the data showed that the overall and disease-free surviva l probabilities of patients having Low tumor lactate values were significan tly higher compared with patients with high tumor lactate concentrations (P = 0.015 and 0.014, respectively). We conclude that tumor lactate content m ay be used as a prognostic parameter in the clinic. Furthermore, these find ings are in accordance with data from the literature showing that the prese nce of hypoxia in cervical tumors is associated with a poorer patient survi val.