ALP、LDH与骨肉瘤预后的相关性

目的评价骨肉瘤息者术前血清ALP、LDH水平与预后的相关性。方法1989-1999年入院手术的65例ⅡB期肢体骨肉瘤患者，所有病例经过3～13年随访，平均7．6年。回顾性分析患者术前ALP、LDH与复发率、无瘤生存率。结果ALP、LDH升高组患者复发率较高、无瘤生存率低，较对照组有显著性差异，尤以LDH组差异明显。ALP、LDH两指标吻合度较强。结论骨肉瘤息者术前ALP、LDH水平可反映其预后，LDH值作为预后的检测指标较ALP更有特异性。

Prognostic Significance of Preoperative Serum ALP and LDH in Osteosarcoma Patients

Purpose To explore the prognostic significance of preoperative serum alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in osteosarcoma patients. Methods We performed a retrospective analysis of 65 patients with non-metastatic limb osteosarcoma that were treated Between 1989 and 1999. Thirty-eight of them were male and twenty-seven were female. They were followed-up for 3-13 years (mean seven years and six months). Results The ALP and LDH levels at diagnosis showed significant correlation with prognosis. Disease-free survival (DFS) was 25% in patients with ALP levels>200 IU/L, and 62.1 % in patients with ALP levels<200 IU/L(P = 0. 003). The local recurrence rates of above two groups were 27.8% and 6. 9% (P = 0. 031). DFS was 20% in patients with elevated LDH level, while 60% in patients with normal LDH level (P = 0. 001). The local recurrence rates of the two groups were 33.3 % and 5.7 % (P = 0.004). The correlation analysis indicated two variables have good coincidence( k -0. 7, P<0.001). Conclusions These data demonstrate that in osteosarcoma of limb pretreatment ALP and LDH have a prognostic value. LDH is more specific than ALP as a prognostic indicator.