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Objective To investigate the clinical value of combined detection of serum carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA199) and tumor type M2 pyruvate kinase (TuM2-PK) for the diagnosis of early colon cancer.Methods A total of 137 patients with colon cancer in the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine from February 2014 to November 2016 were selected as observation group,87 patients with benign colon disease were selected as control group,and 75 healthy subjects were selected as health group.The levels of serum CEA and CA199 were detected by electrochemiluminescence,and serum TuM2-PK level was determined by quantitative enzyme-linked immunosorbent assay.The diagnostic value of single and combined detection on early colon cancer were compared.Results The levels and positive expression rate of serum CEA,CA199 and TuM2-PK in the observation group were significantly higher than those in the control group and the health group(P ＜0.05).There was no significant difference in the levels and positive expression rate of serum CEA,CA 199,TuM2-PK between the control group and the health group (P ＜ 0.05).The sensitivity and Youden index of combined detection of CEA,CA199 and TuM2-PK were better than those of single or two indexes detection(P ＜0.05).The specificity of combined detection of CEA,CA199 and TuM2-PK was better than that of single detection and combined detection of CEA,CA199 (P ＜ 0.05).The combined detection of two or three indexes in CEA,CA199 and TuM2-PK had certain diagnostic value for colon cancer,the area under the receiver operating characteristic curve ≥0.70;and the area under the receiver operating characteristics curve of the combined detection of CEA,CA199 and TuM2-PK was the largest.Conclusion The combined detection of CEA,CA199 and TuM2-PK has the high diagnostic value for colon cancer.
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Objective To investigate the application valve of real-time fluorescence quantitative polymerase chain reaction(RT-PCR) for the detection of tumor M2-pyruvate kinase(tM2-PK) DNA in patients with colorectal cancer(CRC).Methods Fragment of tM2-PK DNA(162 bp) was amplified and inserted into PGM-T vector to construct recombinant plasmid,which was used to develop RT-PCR method.Sensitivity,specificity and repeatability of RT-PCR for the detection of tM2-PK were analyzed.From Jan.2014 to Jun.2016,200 CRC patients and 100 healthy subjects were enrolled and detected for fecal and serum tM2-PK DNA by using RT-PCR,and the detected results were compared with those detected by using enzyme linked immunosorbent assay(ELISA).Results Recombinant plasmid was successfully constructed,which was certified by sequencing.The sensitivity of RT-PCR for the detection of tM2-PK DNA was 10 copy/mL,with high specificity and 0.3%-2.9% of coefficient of variation.In patients,the positive rate of fecal tM2-PK DNA,detected by RT-PCR,was 92.50%,and that of ELISA to detect tM2-PK was 80.00%.Fecal and serum levels of tM2-PK were correlated with the pathologic stages of tumour.Conclusion Self-established RT-PCR could be specificity and sensitivity for the detection of fecal tM2-PK,which could be used for the early diagnosis of CRC.
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Objective To estimate the value of fecal tumor M2-PK in the detection of colorectal adenoma and to evaluate its potential as a screening tool for colorectal adenoma.Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the fecal tumor M2-PK in stool samples of 65 patients with colorectal adenoma and 25 controls.At the same time,the peripheral blood tumor markers such as carcinoembryonic antigen (CEA),carbohydrate antigen (CA) 19-9,CA24-2 and fecal occult blood test (FOBT) were detected in the colorectal adenoma group.Results The detection value of fecal tumor M2-PK in the colorectal adenoma group showed a significant increase,compared with the control group((6.033±4.123) U/ml vs.(2.782±1.464) U/ml,t=-3.839,P=0.000).The highest detection value was found in the group where the diameter of adenoma was greater than or equal to 2 cm ((8.775±6.548) U/ml,t=9.635,P=0.034).The larger the diameter of adenoma,the higher the positive rate of fecal tumor M2-PK (85.7% vs.41.7% vs.29.6%,χ2=11.977,P=0.003).In the colorectal adenoma group,The positive detection rate of fecal tumor M2-PK was significantly higher than that of CEA,CA19-9,CA24-2 and FOBT (46.2% vs.6.2% vs.1.5% vs.1.5% vs.27.7%,?2=76.607,P=0.000).Conclusion Fecal tumor M2 pyruvate kinase has a good clinical value in the diagnosis of colorectal adenoma.
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Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase (TuM2-PK),carcino-embryonic antigen (CEA),CA199,CA724,CA125 and CA242 in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242 in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve (ROC) and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis (PLS-DA) were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Resalts Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724 in the colon cancer group are higher than those in the colon benign diseases group and the normal controls (P＜0.05).The area under the operation working characteristic curve (AUC) of CA199 is the highest 0.79 [95％ confidence interval (95％CI),0.75-0.83] at the cutoff value of 69.5 U/L with 64.1％ of sensitivity and 89.7％ of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum (CEA+ CA199+TuM2-PK) is the optimal [AUC=0.89,95％ confidence interval(95％CI),0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7％ and 77.5％,and for colon cancer is 93.7％ and 95.6％,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.
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BACKGROUND/AIMS: M2 pyruvate kinase (M2-PK) is an enzyme that is produced in undifferentiated and proliferating tissues. This study aims to evaluate the usefulness of the immunochromatographic M2 pyruvate kinase (iM2-PK) for the screening of colorectal cancer (CRC) and premalignant lesions. METHODS: Healthy volunteers and patients with colorectal neoplasia were enrolled in six academic hospitals in the capital province of Korea. The iM2-PK value was compared with the immunochromatographic fecal occult blood test (iFOBT) and fecal tumor M2-PK enzyme-linked immunosorbent assay (ELISA). RESULTS: A total of 323 subjects were enrolled. The sensitivity of iM2-PK for CRC was 92.8%, which was superior to iFOBT (47.5%, p<0.0001). For adenomatous lesions, the sensitivity of iM2-PK was 69.4%, which was also superior to iFOBT (12.1%, p<0.001). Compared with M2-PK ELISA, iM2-PK exhibited significantly enhanced sensitivity for CRC (97.5% vs 80.0%, p=0.0289). The sensitivity of iM2-PK was higher in advanced stages of CRC compared with cancers confined to the mucosa and submucosa (p<0.05). However, lymph node metastasis had no influence on the sensitivity of iM2-PK. CONCLUSIONS: The iM2-PK exhibited increased sensitivity for identifying CRC and adenomatous lesions compared with iFOBT. Given its rapid results and convenience, CRC screening using iM2-PK is promising.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Adenoma/diagnosis , Biomarkers, Tumor/analysis , Clinical Enzyme Tests/instrumentation , Colorectal Neoplasms/diagnosis , Enzyme-Linked Immunosorbent Assay , Feces/enzymology , Healthy Volunteers , Chromatography, Affinity/methods , Occult Blood , Precancerous Conditions/diagnosis , Predictive Value of Tests , Pyruvate Kinase/analysis , Reagent Kits, Diagnostic , Republic of Korea , Sensitivity and SpecificityABSTRACT
Objective To investigate the expression and clinical signification of tumor M2 pyruvate kinase in pa-tients with CRC, and to try to find a reliable and atraumatic method to predict the progress and pronosis in the CRC. Methods ELISA method was used to determine the serum levels of tM2-PK in 68 patients with CRC,40 pa-tients with colorectal polyps and 40 cases of normal subjects; immunohistochemistry ( IHC ) methods were respec-tively used to detect the expression of tM2-PK in tissues. Results ① The level of serum tM2-PK in patients with CRC was significantly higher than the group of patients with polyps and the normal subjects ( P<0.05 ) . The serum tM2-PK levels was closely correlated to tumor size and Duke stage.②The positive rate of tissue tM2-PK was signif-icantly higher in CRC than in colorectal polyps and normal subjects ( P<0.05 ) . Tissue tM2-PK levels was closely correlated to tumor size,Duke stage and differentiation grade. ③Serum tM2-PK levels was correlated to tissue tM2-PK levels (r=0.357,P=0.003). Conclusion Combined detection of expression of tM2-PK can provide the basis theory for the diagnosis and prognosis evaluation of CRC.
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Objective To investigate the value of tumor M2 pyruvate kinase (TuM2-PK ) ,cytokeratin-18 (CK18 )-3A9 and cytokeratin 19 fragment(CYFRA21-1) in non small cell lung cancer(NSCLC) ,and to evaluate the application value of combined de-tection of these three kinds tumor markers in diagnosis of NSCLC .Methods The serum levels of TuM2-PK and CK18-3A9 were measured in 67 patients with NSCLC(NSCLC group) ,72 patients with benign lung diseases(benign group) and 75 healthy control (control group) by enzyme linked immunosorbent assay(ELISA) .The level of CYFRA21-1 was detected by electrochemilumines-cence method .Results The serum levels of TuM2-PK ,CK18-3A9 and CYFRA21-1 in NSCLC group were higher than those in be-nign group and control group(P<0 .05) .The sensitivity of TuM2-PK or CK18-3A9 was better than CYFRA21-1(P<0 .05) ,the specificity of CYFRA21-1 was better than TuM2-PK or CK18-3A9(P<0 .01) .The sensitivity and accuracy of combined detection of TuM2-PK ,CK18-3A9 and CYFRA21-1 were both better than CYFRA21-1(P<0 .05) .The sensitivity ,specificity and accuracy of combined detection of TuM2-PK ,CK18-3A9 and CYFRA21-1 were all better than TuM2-PK or CK18-3A9 alone(P<0 .05) .Con-clusion The combined detection of TuM2-PK ,CK18-3A9 and CYFRA21-1 were better in sensitivity and accuracy of diagnosis of NSCLC .