Tumour M2-PK as a predictor of surgical outcome in ovarian cancer, a prospective cohort study.
BACKGROUND
Optimal cytoreduction is a major prognostic factor in ovarian cancer; several clinical, radiological and biochemical predictors have been studied. Tumour M2-PK (TU M2-PK) is over-expressed in tumour cells and can be detected in plasma samples but its role in ovarian cancer has not yet been evaluated.


OBJECTIVE
To assess the potential clinical applications of TU M2-PK in ovarian cancer particularly in relation to surgical cytoreduction.


METHODS
The Gynaecological Cancer Centre at both King's College and St Thomas' Hospitals; London; UK.


METHODS
Patients with suspected ovarian cancer were recruited prospectively during the years 2004-2005. Blood samples were collected before surgery for plasma TU M2-PK assays. Data were analysed in relation to cancer diagnosis and outcome. Statistical analysis was performed using Analyse-It' and SPSS' V13.


RESULTS
100 patients were recruited; 52 diagnosed with invasive ovarian cancer, 13 with borderline tumours and 35 patients had benign conditions. The mean M2-PK concentration in cancer patients was 52 U/ml vs 31 U/ml in patients with borderline tumours and 22 U/ml in those with benign conditions (p < 0.001); it was significantly raised in association with late stage disease and higher grade (p < 0.05). Taking 35 U/ml as a reference point, TU M2-PK predicted sub-optimal cytoreduction in advanced stage disease with a sensitivity of 69%, specificity of 60% and overall efficacy of 61% (95% CI: 44-75%).


CONCLUSIONS
TU M2-PK was significantly raised in ovarian cancer patients, particularly those with higher stage disease. The potential clinical application as a predictor of surgical outcome in ovarian cancer needs further evaluation.
Ahmed
A S
AS
South East London Cancer Network, Gynae-Oncology Department, Guy's and St Thomas', and King's College Hospitals, London.
Dew
T
T
Lawton
F G
FG
Papadopoulos
A J
AJ
Devaja
O
O
Raju
K S
KS
Sherwood
R A
RA
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008131:London; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods; D011446:Prospective Studies; D011770:Pyruvate Kinase / Q000097:blood*; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D011770:Pyruvate Kinase