Comparison of ESR, ALT, LDH and CRP Levels in Soft Tissue Sarcoma

and Bone Tumors (Sarcoma) pre-chemotherapy in Dr. M. Djamil

Hospital, West Sumatera
Doddy Setya Adi Putra*, Almu Muhamad**

*General Surgery Resident, Dr. M. Djamil Hospital, Andalas University, West Sumatera

**Orthopedic Oncology Consultant, Division of Orthopedic and Traumatology, Dr. M. Djamil Hospital, Andalas University,
West Sumatera

Introduction

The levels of ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), ALP (Alkaline
Phosphatase), and LDH (lactate dehydrogenase) are often evaluated in patients with soft tissue
sarcoma to assess prognosis and predict the efficacy of chemotherapy. LDH values were also
identified as a predictive indicator in evaluating responses to neoadjuvant chemotherapy. In bone
tumors, particularly in osteosarcoma, while ESR is not commonly used as a prognostic indicator for
bone tumors, both CRP and LDH levels have been associated with prognosis, tumor recurrence, and
treatment response in bone tumors. ALP was found to have a certain suggestive effect on
osteosarcoma and was included in a study to predict the efficacy of chemotherapy. Elevated CRP and
LDH levels have been linked to poor prognosis and decreased disease-free survival.

Method Purpose
The clinical data of 30 patient with any bone
tumors (sarcoma) and Soft Tissue Sarcoma This present study aimed to compare a
patients between January 2023 and December laboratory score ESR, CRP, ALP and LDH
2023 in our hospital was retrospectively levels in pre-chemotherapy soft tissue sarcoma
collected and analyzed. Laboratory parameters, and bone tumors (sarcoma).
include ALP, ESR, CRP, and ALP.

Test Statisticsa Test Statisticsa Test Statisticsa Test Statisticsa

ESR ALP LDH CRP
Mann-Whitney U 108,500 Mann-Whitney U 103,000 Mann-Whitney U 92,000 Mann-Whitney U 101,000
Wilcoxon W 213,500 Wilcoxon W 239,000 Wilcoxon W 228,000 Wilcoxon W 206,000
Z -,149 Z -,376 Z -,833 Z -,624
Asymp. Sig. (2-tailed) ,881 Asymp. Sig. (2-tailed) ,707 Asymp. Sig. (2-tailed) ,405 Asymp. Sig. (2-tailed) ,533
Exact Sig. [2*(1-tailed Sig.)] ,886b Exact Sig. [2*(1-tailed Sig.)] ,728b Exact Sig. [2*(1-tailed Sig.)] ,423b Exact Sig. [2*(1-tailed Sig.)] ,667b
a. Grouping Variable: KLP a. Grouping Variable: KLP a. Grouping Variable: KLP a. Grouping Variable: KLP
b. Not corrected for ties. b. Not corrected for ties. b. Not corrected for ties. b. Not corrected for ties.

Result
There were 30 cases, including 14 cases of soft tissue tumor sarcoma, and 16 cases of bone tumors
sarcoma. Elevated ESR, CRP, ALP and LDH occurred in both cases of bone sarcoma and soft
tissue sarcoma. Based on the Man Whitney test, the ESR value 0,881, ALP value 0,707, LDH
value 0,405, dan CRP value 0,533 where this value > 0,05. It can be concluded that there is no
difference values between soft tissue sarcoma and bone sarcoma.

Conclusion

ESR, CRP, ALP and LDH were found significantly increased, both in soft tissue sarcoma and bone
tumors (sarcoma). There is no difference values between soft tissue sarcoma and bone sarcoma.
Elevated levels of ESR, CRP, ALP and LDH are important biomarkers in pre chemotheraphy soft
tissue and bone tumors. Monitoring these biomarkers can provide valuable information in the
management of bone tumors and soft tissue sarcoma.