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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.

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.