Tumor M2Pyruvate Kinase in Patients Suffering from Pancreatic Cancer

Tumor M2Pyruvate Kinase in Patients Suffering from Pancreatic Cancer,E. Coato,L. Frulloni,S. Carrara,S. Brunelli,B. Ferri,B. Calore,L. Bernardoni,K. F

Tumor M2Pyruvate Kinase in Patients Suffering from Pancreatic Cancer  
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Background: Tumour marker pyruvate kinase type tumour M2 has been proposed as a new specific marker for the diagnosis of pancreatic cancer. Aim of the study was to evaluate M2-PK in patients with benign, malignant and metastasic pancreatic lesions and to compare it to the reference marker Ca 19-9. Materials and Methods: We studied 54 healthy volunteers and 103 consecutive patients suffering from pancreatic diseases (49 females, 54 males; mean age 56 13 years): 57 patients from pancreatic cancer (50 adenocarcinoma, 7 intraductal mucin-producing tumour, all histological documented), 30 from chronic pancreatitis and 16 from acute recurrent pancreatitis. Blood samples were evaluated for M2-PK by a commercial Elisa kitt (Schebo Biotech, Glessen, Germania) and for Ca 19-9 (Byk Gulden, Milano, Italia). Results: The M2-PK plasma levels were higher than upper normal limit in 64% of patients with pancreatic cancer, 50% of patient with chronic pancreatitis, 31% of patient with acute recurrent pancreatitis, and in 20% of healthy volunteers (p 0.0001 chi- square test). The sensitivity of M2-PK in diagnosing pancreatic cancer was 64% and specificity 69%, lower than sensitivity and specificity of Ca 19-9, 72% and 94% respec- tively. Metastatic disease was correlated to a significant increment in plasma levels of M2-PK (p 0.001 metastatic disease vs. non metastatic disease), while no differences were found related to the presence of regional or vascular infiltration or tumour site. A contemporary elevation of the two tumour-related markers was more common in pancre- atic cancer (48%) compared to the other groups studied (p 0.0001). Conclusions: Our study shows that M2-PK has a lower sensitivity and specificity in diagnosing pancreatic cancer compared to Ca 19-9. However, in patients with adeno- carcinoma we observe frequently a simultaneous increase of M2-PK and Ca 19-9. In addition, M2-PK is more commonly elevated in metastatic disease and may be an addi- tional criterium to decide on radical surgery of pancreatic cancer.
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