A comparison of several serum
tumor markers (
lactate dehydrogenase (LDH), LDH
isozyme, hydroxybutylrate
dehydrogenase (HBD),
alkaline phosphatase (ALP),
cholinesterase (
Choline-E),
aldolase (ALD),
leucine aminopeptidase (LAP),
gamma-glutamyl transpeptidase (gamma-
GTP),
human chorionic gonadotropin (HCG),
carcinoembryonic antigen (CEA) and alpha 1-
fetoprotein (AFP)) was made in patients with
carcinoma or benign
tumor of the ovary and healthy control subjects. The greatest positive rates were obtained with the markers HBD (76.5%) and
Choline-E (73.3%) for patients with
carcinoma of the ovary, respectively. However, based on false positive results,
Choline-E was also greatest (50.0%) for patients with benign
tumor of the ovary. The lowest false positive rates were obtained with ALD, but the positive rates for patients with stage I and II diseases were 0.0%. The most suitable single marker for patients with stage I and II diseases was HBD (62.5%), followed by LDH (41.7%). Three of 4 patients with early
cancer, who had normal serum LDH levels, showed abnormal LDH
isozyme patterns (elevated
LDH-4 and -5). A combination of LDH activity and LDH
isozyme resulted in an increase in the positive results (41.7% to 70.0%), that is, the
cancer patients were positive for one of the two markers. For CEA, AFP and HCG, the positive results were 26.9%, 19.0% and 7.1%, respectively. Positive and false positive rates for ALP were 36.7% and 7.1%, but the positive rates in the early stage were lower (14.3%), compared to those for LDH and HBD. HBD and LDH activities in the ovarian malignant tissues and ascitic fluids were significantly higher than those in the benign
tumor tissues and ascitic fluids, resulting in a significant elevation of serum LDH and HBD levels in the patients. Moreover, it was suggested that inhibition test of ALP by the inhibitors might be able to identify the tissue origin of ALP in the
cancer patients.