Ervens Juergen, Fuchs Hendrik, Niemann Volker-Till, Hoffmeister Bodo
Department of Maxillofacial & Facial Plastic Surgery, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
J Craniomaxillofac Surg. 2008 Mar;36(2):89-94. doi: 10.1016/j.jcms.2007.08.006. Epub 2008 Feb 4.
Increased aerobic glycolysis is one of the most common abnormalities occurring in the metabolism of tumour cells with pyruvate kinase as one of the key glycolytic enzymes. The dimeric form of M2-pyruvate kinase, found predominantly in tumour cells, is designated as tumour M2-pyruvate kinase (TuM2-PK). The aim of the present, prospective study was to evaluate the diagnostic relevance of TuM2-PK in detecting oral squamous cell carcinoma (OSCC).
TuM2-PK concentration was analysed in ethylene diaminetetraacetic acid plasma of 80 untreated patients with histologically confirmed OSCC stages T3 and T4, whilst 90 patients with non-malignant diseases served as controls. The analysis was done using a sandwich enzyme-linked immunosorbent assay (ScheBo Biotech AG, Giessen, Germany). Immunohistochemical detection of TuM2-PK was performed by specific mouse monoclonal antibody DF-4.
The median TuM2-PK concentration was 22.92U/ml in the tumour group and 10.00U/ml in the control group (p<0.001). Using 15U/ml as a cut-off yielded a sensitivity of 63% and a specificity of 59%. Moreover, the positive and negative predictive values were 57% and 64%, respectively. Immunohistochemical staining of tissue sections showed that TuM2-PK was not selectively expressed in tumour cells but also in non-malignant cells, particularly in more regenerative ones.
Low sensitivity and specificity for stages T3 and T4 OSCC render the TuM2-PK test unsuitable as a tool for detecting OSCC, particularly in an early stage. Thus, routine clinical and radiological follow-up is indispensable after treatment of OSCC.
有氧糖酵解增加是肿瘤细胞代谢中最常见的异常之一，丙酮酸激酶是关键的糖酵解酶之一。主要在肿瘤细胞中发现的M2-丙酮酸激酶二聚体形式被称为肿瘤M2-丙酮酸激酶（TuM2-PK）。本前瞻性研究的目的是评估TuM2-PK在检测口腔鳞状细胞癌（OSCC）中的诊断相关性。
分析了80例未经治疗、组织学确诊为T3和T4期OSCC患者的乙二胺四乙酸血浆中的TuM2-PK浓度，同时90例非恶性疾病患者作为对照。使用夹心酶联免疫吸附测定法（德国吉森的ScheBo Biotech AG公司）进行分析。通过特异性小鼠单克隆抗体DF-4对TuM2-PK进行免疫组织化学检测。
肿瘤组TuM2-PK浓度中位数为22.92U/ml，对照组为10.00U/ml（p<0.001）。以15U/ml作为临界值，敏感性为63%，特异性为59%。此外，阳性预测值和阴性预测值分别为57%和64%。组织切片的免疫组织化学染色显示，TuM2-PK并非在肿瘤细胞中选择性表达，在非恶性细胞中也有表达，尤其是在再生能力较强的细胞中。
TuM2-PK检测对T3和T4期OSCC的敏感性和特异性较低，使其不适用于检测OSCC，尤其是在早期。因此，OSCC治疗后常规的临床和影像学随访必不可少。
