血清乳酸脱氢酶 (LDH) 活性增加被认为是细胞坏死的标志物，并可作为包括头颈鳞状细胞癌 (HNSCC) 在内的多种癌症的代谢组学诊断标志物。 LDH是一种参与糖酵解循环的酶，不仅与HIF-α和Myc等癌基因的激活相关，而且还与肿瘤增殖和转移等作用相关。血清碱性磷酸酶 (ALP) 是细胞分化和肿瘤诱导的标志物。白蛋白与碱性磷酸酶比率（AAPR）由于其易于获取的动态和成本效益，可能是一种有利的生物标志物。在实体瘤病例中，AAPR 值升高可能与更长的总生存期 (OS) 相关。糖尿病 (DM) 可能通过导致胰岛素抵抗和慢性炎症，并参与癌变、疾病进展和转移的各个方面来影响 HNSCC 患者的预后。然而，使用抗高血糖药物（二甲双胍）可以通过抑制肿瘤代谢途径产生有益的作用。 LDH 和 AAPR 在合并 DM 的 HNSCC 患者中的生物标志物作用的评估较少。该研究的目的是评估治疗前血清乳酸脱氢酶（LDH）和白蛋白与碱性磷酸酶比率（AAPR）在预测头颈癌非手术肿瘤治疗和血糖控制持续时间方面的预后价值糖尿病患者，包括从克拉约瓦县医院肿瘤诊所和肿瘤门诊数据库中选择的病例。 LDH 和 AAPR 均可用作预测治疗反应的治疗前生物标志物，或作为与 DM 相关的 HNC 的复杂多参数模型中包含的预后工具。但考虑到短期血糖控制对LDH水平的影响，有必要在评估和控制DM后对这些生物标志物进行评估，建议的临界值设置在0.5左右。由于病例数量有限，有必要通过更多患者的多中心试验来验证结果（表 5，参考文献 50）。关键词：糖尿病、HNC、LDH、AAPR、生物标志物、预测、头颈癌、乳酸脱氢酶、白蛋白与碱性磷酸酶的比率。

Increased serum lactate dehydrogenase (LDH) activity is considered as a marker of cellular necrosis and serves as a metabolomic diagnostic marker in several types of cancer including head and neck squamous cell carcinoma (HNSCC). LDH, an enzyme involved in the glycolytic cycle, is correlated not only with the activation of oncogenes such as HIF-α and Myc, but also with effects such as tumor proliferation and metastasis. Serum alkaline phosphatase (ALP) is a marker of cell differentiation and tumor induction. Albumin-to-alkaline phosphatase ratio (AAPR) could be an advantageous biomarker due to its easily accessible dynamics and cost-effectiveness. Elevated values of AAPR could be associated with longer overall survival (OS) in cases with solid tumors. Diabetes mellitus (DM) could influence the outcome of patients with HNSCC by contributing to insulin resistance and chronic inflammation, and by being involved in various aspects of carcinogenesis, disease progression and metastasis. However, the use of antihyperglycemic medications (metformin) can have beneficial effects by inhibiting tumor metabolic pathways. The biomarker role of LDH and AAPR in HNSCC patients with DM has been less evaluated. The purpose of the study was to assess the prognostic value of pretreatment serum lactate dehydrogenase (LDH) and albumin-to-alkaline phosphatase ratio (AAPR) in predicting the duration of non-surgical oncological treatment and glycemic control in cases of head and neck cancers patients with DM, including cases selected from the database of the oncology clinic and oncology outpatient clinic of the Craiova County Hospital. Both LDH and AAPR can be used as pre-treatment biomarkers predictive of treatment response, or prognostic tools included in complex multi-parametric models in HNC associated with DM. However, given the impact of short-term glycemic control on the LDH level, it is necessary to evaluate these biomarkers after assessing and controlling for DM, and with the recommended cut-off value set around 0.5. Due to the limited number of cases, it is necessary to validate the results in multicentric trials with a larger number of patients (Tab. 5, Ref. 50). Keywords: diabetes mellitus, HNC, LDH, AAPR, biomarkers, predictive, head and neck cancers, lactate dehydrogenase, albumin-to-alkaline phosphatase ratio.