Plasma TM2-PK levels in mycosis fungoides patients - PubMed (original) (raw)

Plasma TM2-PK levels in mycosis fungoides patients

Aslı Hapa et al. Arch Dermatol Res. 2011 Jan.

Abstract

Aerobic glycolysis increases in tumor cells and pyruvate kinase (PK) is one of the key enzymes involved; PK exists in different isoforms in various tissues. Tumor M2-PK (TM2-PK) is one of these isoforms and its expression has been observed in various tumor cells, including lymphocytes, and in lymphoproliferative disorders. The present study aimed to compare plasma levels of TM2-PK and serum levels of two established markers of various lymphoproliferative disorders-lactate dehydrogenase (LDH) and β-2 microglobulin, and to evaluate the role of TM2-PK in drug monitorization and disease activity in mycosis fungoides (MF) patients. The study included 27 MF patients and 46 healthy controls. Among the MF patients, 18 were stage IA, 6 were stage IB, 1 was stage IIA, and 2 were stage III. Plasma TM2-PK, and serum LDH and β-2 microglobulin levels in the patients and controls were measured using the ELISA technique, a kinetic method, and a chemiluminescent assay, respectively. Measurements were repeated in the patient group posttreatment. Median levels of TM2-PK, LDH, and β-2 microglobulin level in the MF patients were 22 U mL⁻¹, 375 U L⁻¹, and 1,831 ng mL⁻¹, respectively. TM2-PK and β-2 microglobulin levels did not significantly differ between the MF patients and controls; however, LDH levels were significantly higher in the MF patients. TM2-PK levels in 17 of the MF patients that were in remission did not significantly differ from their pre-therapy levels. Based on a cut-off point of 17.5 U mL⁻¹, the sensitivity and specificity of TM2-PK for diagnosing MF were 55.6 and 60.9%, respectively. β-2 microglobulin was the most sensitive marker for diagnosing MF (63%), while LDH was the most specific marker. Furthermore, the sensitivity of TM2-PK increased when it was analyzed in combination as parallel tests with LDH and β-2 microglobulin (86%), while the specificity was measured as 32%. In serial analysis, the specificity was increased to 98%, while the sensitivity was 5%. Statistically significant agreement in diagnosing MF was also noted between TM2-PK and LDH levels. TM2-PK may not be a useful marker for MF, especially in early-stage patients, because it proliferates slowly. We think that TM2-PK levels should be investigated in advanced-stage MF or in other types of cutaneous T-cell lymphomas; in particular, in combination with other established markers.

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