Activities of Four Enzymes in Blood Serum Determined Simultaneously in Patients with Malignancy before Radical Surgery

The activities of serum alkaline phosphatase (ALP), glutamicoxaloacetic transaminase (GOT), glutamic pyruvic transaminase(GPT) and lactate de-hydrogenase (LDH) were determined simultaneouslyin a group of healthy subjects (351) and in groups of patientswith carcinoma of the lung (379), the stomach (797), the cervix(293), the breast (865), the liver (30) and the pancreas (6)before radical operation. In general, LDH gave the highest rateof positivity of the four enzymes and the activity of this enzymeabove the upper limit of the normal range (M+2SD) was foundin 44.9, 24.1, 19.1 and 13.0% of the patients with carcinomaof the lung, the stomach, the breast and the cervix, respectively. In the patients with adenocarcinoma of the lung, the positivityof serum LDH activity before surgery was shown to increase withthe size of the radically resected tumor. In the two other carcinomas,however, the serum enzyme with the highest rate of positivitywas not LDH but GOT and ALP in pancreatic carcinoma and GOTin hepatocellular carcinoma. As for the rate of independentelevation of serum enzyme activity, LDH exhibited the highestpercentage in all the carcinomas examined, with the exceptionof pancreatic carcinoma in which ALP showed the highest rate.Combined assays of these four enzyme activities gave positivityrates of 100%, 93.3%, 56.5%, 35.9%, 25.4% and 25.3% in carcinomaof the pancreas, the liver, the lung, the stomach, the breastand the cervix, respectively, demonstrating the practical diagnosticvalue of this combined assay system.