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Tumor M2-Pyruvate Kinase as Tumor Marker in Exocrine Pancreatic Cancer A Meta-Analysis

Kumar, Yogesh MRCS; Gurusamy, Kurinchi MRCS; Pamecha, Vineet MRCS; Davidson, Brian R. MD, FRCS

doi: 10.1097/mpa.0b013e3180537237
Original Articles

Objectives: Tumor M2-pyruvate kinase, a tumor-associated dimeric form of enzyme pyruvate kinase, is commonly elevated in pancreatic cancers. This meta-analysis aimed to evaluate its diagnostic utility in comparison to carbohydrate antigen 19-9 (CA19-9) in pancreatic cancer.

Methods: A literature search was conducted for entries from 1951 to 2006 using PubMed, Embase, Central, and SCI Expanded databases using M2 pyruvate kinase AND pancreatic cancer/s OR tumor/s as keywords. A total of 258 references were retrieved. Of these, 118 duplicates were removed and 132 references were excluded. All studies comparing TuM2-PK with CA19-9 in pancreatic cancer were included. Full text was obtained for 8 references of 7 included studies. Diagnostic odds ratio (DOR) and 95% confidence interval (CI) was calculated from the available specificity and sensitivity for each study and were pooled to give overall DOR and 95% CI for TuM2-PK and CA19-9. Receiver operator characteristic curve was calculated to give overall specificity and sensitivity for TuM2-PK.

Results: The diagnostic performance of TuM2-PK (DOR, 35; 95% CI, 19.7-62.3) was similar to those of CA19-9 (DOR, 44; 95% CI, 26.5-73.1). The overall specificity for TuM2-PK was 60% with corresponding sensitivity of 95%.

Conclusion: Efficacy of TuM2-PK as a tumor marker is similar to that of CA19-9. Further trials are needed to use it alone or in combination with CA19-9 in patients with suspected pancreatic cancer.

Author Information

From the University Department of Surgery, Royal Free and University College Medical School, University College London, London, UK.

Received for publication December 17, 2006; accepted February 26, 2007.

This study was not supported by any grant.

Reprints: Brian R. Davidson, MD, FRCS, University Department of Surgery, Royal Free and University College Medical School, 9th Floor, Royal Free Hospital, Pond St, London NW3 2QG, UK (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.