[Faecal pyruvate kinase type M2--a valid screening parameter for colorectal cancer? Preliminary results from a multicenter comparative study].
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Adenoma↗
Biomedical subjects
G M Oremek
Publications and source records attributed to G M Oremek.
Kinetic differences between creatine kinase-isoenzyme MB (CK-MB) and c-troponin-T in patients with myocardial damage.
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Algorithms↗
Physical activity releases prostate-specific antigen (PSA) from the prostate gland into blood and increases serum PSA concentrations.
Determination of prostate-specific antigen (PSA) is an established tool in detecting prostate cancer. However, the effect of physical activity on the PSA concentration in serum is controversial. We measured serum concentrations of PSA and prostatic acid phosphatase (PAP) in 301 healthy outpatients before and after they performed standardized exercise. Immediately after 15 min of exercise on a bicycle ergometer, their serum PSA concentrations increased by as much as threefold. The increase was age dependent and correlated to the PSA concentration before exercise. This increase was evident in both the free and complexed fractions of PSA. The amount of PSA secreted into blood depends on the volume of the prostate, whereas productivity of the prostate epithelium remains constant or increases slightly with age. We present cutoff values for clinical use. PAP was also increased, but to a lesser extent. The PSA and PAP secretion mechanisms differ. Our data suggest that extensive physical activity should be avoided before blood sampling for diagnostic purposes and, in case of an increase, the PSA concentration should be controlled after an exercise test.
Acid Phosphatase↗
[Cyfra 21-1--a new tumor marker of the cytokeratin series in differential diagnosis of lung diseases].
BACKGROUND: Cyfra 21-1 is a novel marker for non small cell lung cancer. Up to now only few data about the value of Cyfra 21-1 in the diagnosis of malignant and non-malignant pulmonary diseases are available. Further the effect of long-time cigarette consumption on serum concentrations of Cyfra 21-1 has not been described. Aim of this study therefore was the determination of Cyfra 21-1 in different malignant and non-malignant pulmonary diseases and in healthy smokers and nonsmokers. PATIENTS: Sera of healthy individuals (control group, n = 121; 63 smokers and 58 nonsmokers), patients with chronic bronchitis (n = 50), lung fibrosis (n = 38), exogen allergic alveolitis (n = 32), lung tuberculosis (n = 45), sarcoidosis (n = 30), small cell lung cancer (n = 60), squamous cell carcinoma (n = 53), non-small cell carcinoma (n = 29) and adenocarcinoma (n = 52) were analyzed. RESULTS: Within the control group no significant differences of the Cyfra 21-1 serum concentration were observed between smokers and nonsmokers. Serum concentrations of Cyfra 21-1 were similar in the control group, patients with non-malignant pulmonary diseases and patients with small cell lung cancer whereas serum concentrations were significantly increased in patients with non-small cell lung cancer, adenocarcinoma and squamous cell carcinoma. CONCLUSIONS: The data confirm the high sensitivity and specific of Cyfra 21-1 for the differential diagnosis between malignant and non-malignant pulmonary diseases as well as small cell and non-small cell lung cancer.
Adolescent↗
The pyruvate kinase isoenzyme tumor M2 (Tu M2-PK) as a tumor marker for renal carcinoma.
Various isoforms of the glycolytic enzyme pyruvate kinase are expressed in different cell-types. One of these isoforms, the type Tu M2-PK, is strongly overexpressed by tumor cells and released into body fluids. The concentration of Tu M2-PK in body fluids can be quantitatively determined by a commercially available enzyme-linked immunosorbent assay (ELISA)-kit. Using this kit, the Tu M2-PK concentration was measured in EDTA-plasma of 64 patients with renal carcinoma and 10 patients suffering from nephritis. The ranges of the Tu M2-PK-concentrations of the two groups did not overlap, indicating a highly significant discrimination of renal carcinoma and benign renal diseases. Furthermore, the Tu M2-PK-concentration in EDTA-plasma correlates strongly with the Robson tumor stage of the 64 patients. The present results indicate that the Tu M2-PK might be the first tumor marker which could be an excellent complementation of the diagnostic program for renal carcinoma.
Biomarkers, Tumor↗
Value of tumor M2 (Tu M2-PK) in patients with renal carcinoma.
Pyruvate kinase is one of the glycolytic key enzymes. It exists in various isoforms which are expressed in different cell types. One of these isoforms, the type Tu M2-PK, is strongly overexpressed by tumor cells and released into body fluids. The concentration of Tu M2-PK in body fluids can be quantitatively determined by a commercially available enzyme-linked immunosorbent assay (ELISA)-kit. The Tu M2-PK concentration was measured in EDTA-plasma of 116 patients with renal carcinoma and 42 patients suffering from nephritis, by using this kit. The ranges of the Tu M2-PK-concentrations of the two groups did not overlap, indicating a highly significant discrimination of renal carcinoma and benign renal diseases. Furthermore, the Tu M2-PK concentration in EDTA-plasma correlated strongly with the Robson tumor stage of the 116 patients. The present results indicated that the Tu M2-PK might be the first tumor marker, which could be an excellent complementation of the diagnostic program for renal carcinoma.
Biomarkers, Tumor↗
Phospholipids, tumour marker and beta-CrossLaps in diagnosis of gastric carcinoma.
INTRODUCTION: The aim of this study was to evaluate the effectiveness of the serum tumor marker levels of CEA, CA 19-9, CA 72-4 and beta-CrossLaps in gastric cancer patients. As an additional parameter, we investigated the membrane phospholipid profile of gastric cancer patients. MATERIALS AND METHODS: We measured the tumor marker and phospholipid concentrations in 40 patients suffering from gastric cancer, 12 patients suffering from pancreatitis and 40 patients with gastric ulcera. We used the Elecsys 2010 enzyme analyser to determine the concentrations of CEA, CA 19-9, CA 72-4 and beta-CrossLaps. Phospholipid fractions were determined by HPLC. RESULTS: Preoperative serum levels of CEA, CA 19-9 and CA 72-4 showed sensitivities of 47.5%, 68% and 76%, respectively. The sensitivity of beta-CrossLap was 63% for non-metastatic and 76% for metastatic gastric cancer. The phospholipid fraction of phosphatidyl ethanolamine showed elevated concentrations. CONCLUSION: Additional prognostic information can be obtained using the combined assay of these tumor markers in gastric cancer patients.
Antigens, Tumor-Associated, Carbohydrate↗
Pro-gastrin-releasing peptide (Pro-GRP), a tumor marker for small cell lung cancer.
INTRODUCTION: Gastrin-releasing peptide (Pro-GRP), a member of the bombesin family of peptides, has been shown to have mitogenic activity in small cell lung carcinoma (SCLC), and to be produced by SCLC in an autocrine fashion. We investigated the usefulness of serum pro-gastrin-releasing peptide (Pro-GRP) as a tumor marker for diagnosis, treatment and monitoring of patients with small cell lung cancer (SCLC). MATERIALS AND METHODS: This study comprised 80 healthy individuals. Serum samples were also obtained from 80 patients with small cell carcinoma, 20 with chronic bronchitis, 30 with sarcoidosis and 20 with lung fibrosis. The cut-off level of serum Pro-GRP was set at 34.2 pg/ml. RESULTS: The levels of Pro-GRP in the patients with benign diseases were significantly higher than those in the healthy group. The serum Pro-GRP levels were elevated in SCLC patients. The elevation was significantly higher than that of the benign reference group. CONCLUSION: These results show that Pro-GRP may be a potential tumor marker for small cell lung carcinoma.
Biomarkers, Tumor↗
Complexed PSA in routine diagnosis.
INTRODUCTION: Prostatic tumor tissue produces a more complex form of PSA (cPSA) than free PSA (fPSA). For the early detection of prostate cancer, cPSA is supposed to be more sensitive than the ratio of fPSA and tPSA. The aim of the study was to evaluate the diagnostic value of cPSA in the early detection of malignant prostatic tumor. MATERIALS AND METHODS: We evaluated the new cPSA test comparing it with the already routinely used fPSA and tPSA test. The study comprised a total of 100 patients with different urological symptoms attending the Division of Urology, University of Frankfurt, Germany. Biopsy and histological examination were performed in all cases. The histological report was compared with the laboratory results obtained by immunological and electrochemiluminescence methods. RESULTS: Forty-one had a benign tumor of the prostatic gland and 59 had a malignant process diagnosed by histological examination. The cut-off level for cPSA was at 2.3 ng/ml. Within a range of 2.0-4.0 ng/ml tPSA and a cut-off of 2.3 ng/ml for cPSA we found a tumor sensitivity of the test in 92%, proved by the histological report. cPSA allows the detection of a malignant process at an earlier stage than tPSA and even within a "normal-range" of tPSA between 2.0-4.0 ng/ml. A concentration of tPSA between 4.1 and 10 ng/ml represents a grey zone. With measurement of cPSA we achieved, in 71% of our cases, a more specific result than in obtaining the PSA ratio. We did not observe any adverse result in the concentration of cPSA concerning manipulation of the prostatic gland as seen before in the measurement of fPSA. cPSA is much more stable regarding transportation and storage. There is no loss of concentration level observed up to -20 degrees C, whereas fPSA shows a loss of 10%. CONCLUSION: We conclude that the new tumor marker cPSA is more specific in the concentration range of tPSA from 2.0-4.0 ng/ml, as well as in the grey zone between 4.0-10 ng/ml.
Adult↗
Diagnostic value of bone and tumour markers in patients with malignant diseases.
INTRODUCTION: Biochemical bone markers, such as the bone isoenzyme form of alkaline phosphatase, have been used to assess the bone formation phase of bone turnover in health and disease. Skeletal metastases often occur in patients with malignancies. Recent developments suggest that bone markers could be valuable clinical tools for the management of patients with metastatic bone disease. PATIENTS AND METHODS: Serum levels of BAP, along with serum levels of beta-CrossLap, were measured in a large group (n = 200) of patients with newly-diagnosed or progressive cancer of the prostate, breast, colon, liver and pancreas. Tumour markers such as PSA, CEA, CA 19-9, AFP, CA 15-3 and bone marker levels were correlated with the presence or absence of bone scan-documented metastases. RESULTS: Both of the bone markers examined were elevated in a high proportion of patients with confirmed metastases to bone. All patients with prostate, breast and colon carcinoma showed elevated beta-CrossLap values. The determined values of beta-CrossLap and BAP were significantly correlated with the number of skeletal metastases. CONCLUSION: Markers of biochemical bone remodeling can be used in assessing and managing patients with malignancies that metastasize to bone. These markers are abnormally raised in the blood of patients with metastatic bone disease.
Alkaline Phosphatase↗
Pre-analytical problems in the measurement of tumor type pyruvate kinase (tumor M2-PK).
INTRODUCTION: Tumor M2-PK is an isoform of the glycolytic enzyme pyruvate kinase. This isoform exists in an active tetrameric and less active dimeric form. The dimeric form is expressed by various tumor cells and can be measured in blood by a specific ELISA. MATERIALS AND METHODS: We included 500 healthy persons, 20 patients with an acute rheumatic disease (high CRP) and 30 patients with a nephropathy and proteinuria with more than 20 mg/dl. We measured Tumor M2-PK in each of these groups in different specimens of EDTA-plasma, serum, heparin-, citrate-, fluoride- and oxalate-plasma. RESULTS: We found different concentrations of Tumor M2-PK in healthy persons depending on the kind of specimen. The normal range of Tumor M2-PK concentration was higher in the serum than in the plasma, with 35 U/l compared to 15 U/l. In haemolytic material we found concentrations up to 80 U/l in healthy persons. Lipaemic or icteric serum material showed a higher concentration of Tumor M2-PK as well. In patients with a triglyceride concentration higher than 300 mg/dl, the normal range for Tumor M2-PK was measured between 30-50 U/l. Similar results were found in patients with icteric serum. Patients with an active rheumatic disease and elevated CRP concentration showed a Tumor M2-PK concentration between 40-60 U/l. Patients with a nephropathy and proteinuria over 20 mg/dl had an elevated Tumor M2-PK concentration from 25-60 U/l. CONCLUSION: We conclude that different materials seem to be suitable for the measurement of Tumor M2-PK concentration as long as attention is paid to different normal ranges. Haemolytic material should not be used as it offers false-positive results. Some diseases such as rheumatic disease, hyperlipidaemia and nephropathy have an influence on Tumor M2-PK concentration that should not be neglected.
Biomarkers, Tumor↗
Pyruvate kinase type tumor M2 plasma levels in patients afflicted with rheumatic diseases.
BACKGROUND: Since tumor markers can be increased in the course of many benign diseases, the aim of this study was to verify if this also occurs in the course of rheumatic diseases. MATERIALS AND METHODS: We investigated the incidence and characteristics of Tumor M2-PK in the EDTA-plasma of 137 patients suffering from rheumatic diseases. RESULTS: The tumor M2-PK concentration was increased in 52 out of 63 patients (82%) with classical rheumatoid arthritis, in 15 out of 21 patients (71%) with systemic lupus erythematosus, in 14 out of 17 patients (82%) with seronegative spondylarthritis and in 13 out of 28 patients with miscellaneous rheumatic diseases (46%). Malignant neoplasm was not detected in any of the patients with rheumatic diseases. CONCLUSION: These results demonstrated that the EDTA-plasma concentrations of Tumor M2-PK were increased in patients with rheumatic diseases.
Arthritis, Rheumatoid↗
Tumor M2-PK levels in haematological malignancies.
Circulating Tumor M2-PK serum levels were measured in 118 patients with various haematological malignancies. Using 17.5 U/ml as the cut-off level, elevated Tumor M2-PK concentrations were found in 7 out of 35 patients with acute myelocytic leukaemia, 17 out of 38 patients with chronic myelocytic leukaemia, 5 out of 18 patients with chronic lymphocytic leukaemia and in 6 out of 14 patients with acute lymphocytic leukaemia. Only 9 out of 195 healthy control individuals had Tumor M2-PK plasma levels above 17.5 U/ml. Serial determinations of Tumor M2-PK were performed in 3 patients with haematological malignancies during chemotherapy. Disease regression was associated with alternating Tumor M2-PK plasma levels. Thus, Tumor M2-PK is not a useful indicator of haematological malignancies. Moreover, serial Tumor M2-PK measurement may be insignificant in monitoring response to chemotherapy in these patients.
Biomarkers, Tumor↗
Tumor marker pyruvate kinase type tumor M2 in patients suffering from diabetic nephropathy.
INTRODUCTION: Compared to normal tissues all tumors investigated so far and especially those with a metastatic potential overexpress an isoenzyme of the pyruvate kinase, the pyruvate kinase type tumor M2 (TU M2-PK). Because of its monomeric structure, the TU M2-PK has no function at all. PATIENTS AND METHODS: Using an enzyme-linked immuno sorbent assay (ELISA) developed by ScheBooTech (Wettenberg, Germany) we measured the concentration of TU M2-PK in EDTA-plasma of 12 probands with insulin-dependent diabetes mellitus and 91 patients suffering from non-insulin-dependent diabetes mellitus, both with diabetic nephropathy. Moreover we focused on the way it compares to other metabolic markers such as HbA1c, glucose and proteins. RESULTS: Among the 12 patients afflicted by insulin-dependent diabetes mellitus 17%, and the 91 probands with non-insulin-dependent diabetes mellitus as many as 19% of the samples were raised over the cut-off of 25 U/ml EDTA-plasma. A correlation with the other investigated parameters could not be found. CONCLUSION: This study shows that the TU M2-PK in EDTA-plasma of patients with diabetic nephropathy presents 38.8% "false-positive" data and thus must be questioned as a tumor marker.
Biomarkers↗
Value of the serum levels of the tumor marker TUM2-PK in pancreatic cancer.
The monoclonal antibody pyruvate kinase type tumor M2 (TUM2-PK) has been shown to have a high binding capacity to pancreatic cancer. In present study TUM2-PK serum levels were measured in pancreatic cancer and compared with the reference tumor markers CA19-9, CA50, CA72-4 and CEA. Overall 100 patients were included in this study, 64 patients had a histologically confirmed pancreatic carcinoma, 36 patients gastrointestinal cancer (stomach, colon), 666 healthy volunteers served as controls. Measurements were done by enzymimmunoassay. For the healthy blood donors a cut-off value of 22.5 U/ml was evaluated, which corresponds to 95% specificity. In patients with pancreatic cancer the sensitivities of TUM2-PK, CA19-9, CEA, CA72-4 and CA50 were 71%; 68%, 37%, 49% and 63.4% respectively. Linear regression analysis indicated that there was a positive correlation (r = 0.79). According to the results of our study TUM2-PK has comparable sensitivity but higher specificity than the reference tumor marker CA19-9.
Biomarkers, Tumor↗
Diagnostic value of skeletal AP and PSA with respect to skeletal scintigram in patients with prostatic disease.
The aim of this study was to compare the diagnostic value of skeletal AP and PSA with the skeletal scintigram in patients with prostatic cancer. PSA and skeletal AP were measured by Tandem-R-Ostase Assay (IRMA) and Tandem-R-PSA-Assay. 64 patients with prostatic cancer, 20 of them in stage D2 were involved. Patients with a prostatic cancer and bone metastases show remarkable increased skeletal AP concentration with a median concentration of 50ng/ml SAP and 95 ng/ml PSA. Patients without bone metastases have a lower median concentration of SAP at 10 ng/ml and PSA concentration of 40 ng/ml which is within the normal range. Six out of 20 patients at stage D2 showed a significant increase of SAP concentration and even of PSA before bone metastases were seen by skeletal scintigraphy. We conclude when skeletal metastases are assumed in patients with prostatic cancer, a combination of skeletal scintigramm and measurement of SAP seem to be of advantage to recognize patients with bone metastases earlier.
Alkaline Phosphatase↗