The Predictive Value of Lactate Dehydrogenase (LDH) for Lymphovascular Invasion in Endometrial Cancer: a...

This study aims to explore the predictive value of serum lactate dehydrogenase (LDH) for lymphovascular invasion in endometrial cancer.

A retrospective analysis was performed on a cohort of 147 patients diagnosed with endometrial cancer at Fujian Provincial Cancer Hospital between January 2018 and January 2020. The study focused on preoperative relevant test indicators, including lactate dehydrogenase (LDH) levels and the extent of postoperative lymphovascular invasion (LVI). Patients were stratified based on the degree of LVI, and intergroup differences were assessed using the chi-squared test (χ²). Stratification was conducted according to the median values of LDH, CA125, glucose (Glu), and Ki67. Survival analyses and comparisons of differences were executed using Kaplan-Meier survival curves and the log-rank test. Spearman's rank correlation coefficient was used to perform a correlation analysis between LDH and other biological indicators. Independent prognostic factors influencing patient outcomes were identified via multivariate Cox regression analysis. A prognostic nomogram was subsequently developed from the Cox regression results to estimate survival probabilities at 1, 2, and 4 years. Furthermore, the predictive efficacy of LDH was assessed through the construction of time-dependent receiver operating characteristic (ROC) curves. A p-value of less than 0.05 was deemed statistically significant.

The levels of serum lactate dehydrogenase (LDH), cancer antigen 125 (CA125), glucose (Glu), and Ki67 were significantly elevated in the group with lymphovascular invasion (LVI+) compared to the group without lymphovascular invasion (LVI-) (p < 0.05). Elevated LDH levels were inversely associated with patient survival log-rank p < 0.05), whereas no significant associations were observed between CA125, Glu, Ki67 levels, and patient survival. Spearman's correlation analysis revealed a significant correlation between LDH and Glu levels (p < 0.05). Cox regression analysis identified LDH as an independent prognostic factor, with elevated LDH levels increasing the risk of mortality by 2.120 times (95% confidence interval: 1.351 - 3.327, p = 0.001). The prognostic nomogram demonstrated that patients with lower total scores had higher probabilities of survival at 1, 2, and 4 years. Time-dependent receiver operating characteristic (ROC) analysis indicated that the predictive efficacy of LDH was limited, with area under the curve (AUC) values of 0.654, 0.653, and 0.719 for 1, 2, and 4 years, respectively.

Lactate dehydrogenase (LDH) can serve as a potential biomarker for assessing lymphovascular metastasis and prognostic outcomes in endometrial cancer.