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Diagnostic and prognostic value of plasma tumor M2 pyruvate kinase in periampullary cancer : evidence for a novel biological marker of adverse prognosis.

Goonetilleke, K. S. and Mason, J. M. and Siriwardana, P. and King, N. K. and France, M. W. and Siriwardena, A. K. (2007) 'Diagnostic and prognostic value of plasma tumor M2 pyruvate kinase in periampullary cancer : evidence for a novel biological marker of adverse prognosis.', Pancreas., 34 (3). pp. 318-324.

Abstract

Objective: This prospective study examines the diagnostic and prognostic use of tumor-M2-pyruvate kinase (Tu-M2-PK) used in conjunction with carbohydrate antigen (CA) 19-9 in patients with subsequently histologically confirmed periampullary malignancy. Methods: Plasma Tu-M2-PK and serum CA 19-9 levels were measured at admission in a cohort of patients with suspected pancreatic cancer. Values for Tu-M2-PK and serum CA 19-9 were compared with a control group comprising jaundiced patients in whom malignancy was excluded by endoscopic retrograde cholangiopancreatography and nonjaundiced individuals undergoing laparoscopic cholecystectomy. Results: The mean (SD) plasma Tu-M2-PK level for patients with histologically proven malignancy was 40.5 (26.4) U/mL and for noncancer patients, 29.9 (20.9) U/mL (Mann-Whitney U = 1163, P = 0.006). Tumor-M2-pyruvate kinase had an area under the curve of 0.623 on receiver operating characteristic curve analysis, and at optimal cutoff of 27 U/mL, sensitivity is 66%, and specificity is 58%.However, on multivariate Cox regression modeling, elevated Tu-M2-PK (>27 U/mL) was strongly correlated with the subsequent finding of poorly differentiated cancer and/or metastatic disease and strongly predicted survival on Kaplan-Meier analysis. Conclusion: An elevated Tu-M2-PK more than 27 U/mL measured on admission in suspected periampullary cancer is a predictor of adverse prognosis in periampullary cancer.

Item Type:Article
Full text:PDF - Accepted Version (400Kb)
Status:Peer-reviewed
Publisher Web site:http://dx.doi.org/10.1097/MPA.0b013e31802ee9c7
Publisher statement:This is a non-final version of an article published in final form in Goonetilleke, K. S. and Mason, J. M. and Siriwardana, P. and King, N. K. and France, M. W. and Siriwardena, A. K. (2007) 'Diagnostic and prognostic value of plasma tumor M2 pyruvate kinase in periampullary cancer : evidence for a novel biological marker of adverse prognosis.', Pancreas., 34 (3). pp. 318-324.
Record Created:13 May 2010 13:20
Last Modified:06 Dec 2011 10:24

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