A systematic review of lactate dehydrogenase isoenzyme 1 and germ cell tumors

Objectives: To evaluate lactate dehydrogenase isoenzyme 1 (LD-1) as a tumor marker of germ cell tumors. Methods: A literature search included a CancerLit and Medline computer sear ch of articles regarding germ cell tumors and LD-1 published between 1963 t o 99 and a manual search of reference lists, theses, and textbooks. Forty a rticles, letters to the editor, and abstracts on testicular germ cell tumor s and 10 articles on ovarian germ cell tumors fulfilled inclusion criteria. Results: Of 696 patients with testicular germ cell tumors, 423 (61%) had a raised serum LD-1 catalytic concentration (S-LD-1). Patients with seminoma have a raised S-LD-1 more often (63%) than those with nonseminoma (60%). S- LD-1 was raised less often in patients with stage I (48%) than in those wit h stage II (50%) and stage III (67%). S-LD-1, serum alpha fetoprotein conce ntration (S-AFP), and serum human chorionic gonadotropin concentration (S-h CG) were discordant. S-LD-1 predicted outcome in four studies: one study re garding relapse in patients with nonseminomatous testicular germ cell tumor s stage 1, and three studies regarding survival of patients with metastatic testicular germ cell tumors. In two of three studies, S-LD-1 was a better prognostic predictor for patients with metastatic testicular germ cell tumo rs than S-LD. Of 40 patients with ovarian germ. cell tumors, thirty-five (8 8%) had a raised S-LD-1. Conclusions: S-LD-1 is a useful serum tumor marker of testicular germ cell tumors. For patients with ovarian germ cell tumors, S-LD-1 was raised more often than for patients with testicular germ cell tumors. Further studies a re required for a general recommendation regarding the use of S-LD-1 for ge rm cell tumors. (C) 2001 The Canadian Society of Clinical Chemists. All rig hts reserved.