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Updated: Sep 25, 2025
Mapping Metabolism: Monitoring Lactate Dehydrogenase Activity Directly in Tissue
Published on: June 21, 2018
Diagnostic Value of Lactate Dehydrogenase and Uric Acid as Screening Tools for Malignancies in Children
Irene A Oriaifo1, James M Gerard, Scott M Thomas
1From the Division of Pediatric Emergency Medicine, Department of Pediatrics, Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St Louis, MO.
Insights
Lactate dehydrogenase (LDH) and uric acid (UA) show potential in diagnosing childhood malignancies. LDH demonstrated higher diagnostic accuracy, particularly for leukemia, compared to UA in this pediatric study.
Area of Science:
- Pediatric Oncology
- Biomarker Research
- Diagnostic Accuracy Studies
Background:
- Early and accurate diagnosis of childhood malignancies is crucial for effective treatment.
- Lactate dehydrogenase (LDH) and uric acid (UA) are established biomarkers, but their specific diagnostic utility in pediatric cancer evaluation requires further clarification.
Purpose of the Study:
- To assess the diagnostic value of serum lactate dehydrogenase (LDH) and uric acid (UA) levels in identifying malignancies in children.
- To compare the sensitivity and specificity of LDH and UA in differentiating between various types of pediatric cancers.
Main Methods:
- Retrospective chart review of 605 pediatric patients (0-18 years) evaluated for malignancy.
- Inclusion criteria: LDH and/or UA levels drawn; exclusion criteria: pre-existing cancer diagnosis.
- Calculation of sensitivity, specificity, and receiver operating characteristic (ROC) curves for LDH and UA.
Main Results:
- 15.7% of subjects were diagnosed with malignancy (49 leukemia, 46 non-leukemia).
- Both LDH and UA exhibited higher sensitivity than specificity for detecting malignancies.
- Area under the curve (AUC) values for LDH were 0.848 (leukemia) and 0.719 (non-leukemia), while for UA they were 0.681 (leukemia) and 0.555 (non-leukemia).
Conclusions:
- LDH demonstrates superior diagnostic performance compared to UA in pediatric malignancy evaluation, especially for leukemia.
- While sensitive, the specificity of both LDH and UA is limited for diagnosing childhood cancers.
- These biomarkers may serve as adjuncts in the diagnostic workup of pediatric malignancies.
Objective:
The aim of this study was to determine the diagnostic value of lactate dehydrogenase (LDH) and uric acid (UA) in children undergoing evaluation for possible malignancies.
Methods:
This was a retrospective chart review of patients aged 0 to 18 years presenting to an urban, tertiary care, pediatric hospital between July 1, 2011, and July 1, 2016. Patients were included if they had an LDH and/or UA level drawn, and they were excluded if they had a known cancer diagnosis. Sensitivity, specificity, and receiver operating characteristic curves were calculated for each biomarker.
Results:
Six hundred five subjects were included in this study; 579 and 384 subjects had LDH and UA levels drawn, respectively; 15.7% had a final diagnosis of malignancy (49 leukemia, 46 nonleukemia).
Conclusion:
The specificities of both biomarkers for all types of malignancies were lower than their respective sensitivities. Comparing leukemic versus nonleukemic malignancies, the areas under the curve were 0.848 and 0.719, respectively, for LDH and 0.681 and 0.555, respectively, for UA.
