LDH in testicular cancer

Last reviewed 01/2018

  • LDH - is an enzyme consisting of five isoforms (each with four subunits) that is expressed in cardiac and skeletal muscle as well as in other organs.
  • the LDH-1 isoenzyme is most often found in testicular germ cell tumours (1,2). However, high levels can also occur in a number of benign conditions including skeletal muscle disease, myocardial infarction, pernicious anaemia, leukaemia, thalassaemia, and pulmonary embolism. Concentrations may also be increased artifactually (e.g. following in vitro haemolysis of blood specimens) (3). Total LDH appears to be less specific than alpha-feto protein (AFP) and human chorionic gonadotrophin (HCG) but nevertheless can be of independent prognostic value in patients with advanced germ cell tumours (sensitivity ~60% for non-seminomatous germ cell tumours (NSGCT); ~80% for seminomas)


  1. Albrecht W, Bonner E, Jeschke K, Stoiber F, Schmidt PR, Scheiber K, et al and the Austrian Uro-Oncology Group: PLAP as a marker in germ cell tumors. In: Appleyard I, Jones WG, Harnden P (ed.): Advances in the biosciences: germ cell tumors IV. John Libbey & Co Ltd, London, Paris, Rome, 1998, pp. 105-109.
  2. von Eyben FE, Blaabjerg O, Madsen EL, Petersen PH, Smith-Sivertsen C, Gullberg B: Serum lactate dehydrogenase isoenzyme 1 and tumour volume are indicators of response to treatment and predictors of prognosis in metastatic testicular germ cell tumours. Eur J Cancer 28: 410-415, 1992.
  3. Doherty AP, Bower M, Christmas TJ: The role of tumour markers in the diagnosis and treatment of testicular germ cell cancers. Br J Urol 79: 247-252, 1997