Current Status of Tumor M2 Pyruvate Kinase (Tumor M2-PK) as a Biomarker of Gastrointestinal Malignancy
Tumor pyruvate kinase M2 (tumor M2-PK) is a key enzyme in the altered metabolism of tumor tissue. In cancer, it is known to be present in high concentrations in malignant tissue, plasma and other body fluids. A commercial enzyme-linked immunosorbent assay (ELISA) method exists for the detection of tumor M2-PK. This study undertakes a systematic review of the current literature on tumor M2-PK as a diagnostic tool and provides an overview of the current usage and scope of this emerging biomarker.
The MEDINE and EMBASE databases were searched for English-language articles containing original data. MeSH headings used were pyruvate kinase, tumor and cancer. All case reports and review articles were excluded and a final study population of 30 manuscripts containing original data was obtained.
Eight articles evaluated plasma tumor M2-PK in 511 esophago-gastric cancer, 226 pancreatobiliary cancer and 470 colorectal cancer patients. Although there are inter-study variations in cut-off points, consistent findings include elevated levels in patients with malignancy with the degree of elevation corresponding to extent of disease.
Tumor M2-PK is elevated in a range of gastrointestinal malignancy. In pancreatobiliary malignancy, the weight of evidence suggests that the test can be used as an adjunctive diagnostic test in conjunction with CA 19-9 and also that it may be a valuable biomarker of adverse prognosis. Stool tumor M2-PK appears to be a promising test for colon cancer.
KeywordsTumor M2 Pyruvate kinase Pancreatic cancer Cancer diagnosis
- 12.Zwerschke W, Mazurek S, Eigenbrodt, et al. Modulation of type M2 pyruvate kinase activity by the human papillomavirus type 16 E7 oncoprotein. Proc Natl Acad Sci USA 1999;96:1291–6Google Scholar
- 14.Eigenbrodt E, Reinacher M, Scheefers, Borchel U, Scheefers H, Friis R. Double role for pyruvate kinase type M2 in the expansion of phosphometabolite pools found in tumor cells. Critical reviews in oncogenesis. Crit Rev Oncog 1992;3:91–115Google Scholar
- 26.Zhang B, Chen J, Chen D, Wang G, Shen P Tumor type M2 pyruvate kinase expression in gastric cancer, colorectal cancer and controls. World J Gastrenterol 2004;10:1643–6Google Scholar
- 29.Cherwenka H, Aigner R, Bacher H, et al. TUM2-PK (Pyruvate kinase type tumor M2), CA 19-9 and CEA in patients with benign, Malignant and metastasizing pancreatic lesions. Anticancer Res 1999;19:849–52Google Scholar
- 32.Hartd P, Mazurek S, Toepler M, et al. Fecal tumor M2 Pyruvate kinase : A new sensitive screening tool for colorectal cancer. Br J Cancer. 2004;91:980–4Google Scholar
- 39.Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer. Eur J Surg Oncol 2006 [Epub ahead of print]Google Scholar