Evaluation of Serological Markers ProGRP, CgA, NSE and TUM2-PK in Patients With Malignant Neuroendocrine Tumors
Assessment of the anatomical spread and disease progression in neuroendocrine tumor
patients has become an essential part of disease management, but sometimes in many patients
difficult to be measured. Therefore, the evaluation of serum markers could represent a
useful tool for monitoring the course of the disease and the response of patients to therapy
or palliative treatment.Clinical data considers CgA and NSE as available today blood
biomarkers for neuroendocrine tumors.Until now the usefulness of serum ProGRP as a clinical
tumor marker has been evaluated mainly in Small Cell Lung Carcinoma, while its role in the
management of NE tumors has not been elucidated.Available in the literature limited data
suggests that ProGRP may be a potential tumor marker in NE tumors.
Pyruvate kinase type M2 is the key glycolytic regulator in tumor cells.It catalyzes the
dephosphorylation of phosphoenolpyruvate to pyruvate with ATP production.The dimeric form of
this enzyme (TUM2-PK) has been detected in the blood of patients with different cancers.High
TUM2-PK expression was suggested to be an important element of tumor cell metabolism
adaptation to an inadequate oxygen and nutrient supply.Recently, it has been shown that
somatostatin and its structural analogues pass through cell membrane and actively bind to
cytosolic TUM2-PK. In response to this binding TUM2-PK translocates into the nucleus and
induce programmed cell death. It is suggested that TUM2-PK enzyme may contribute
significantly to response of neuroendocrine tumors to somatostatin analogues.
Observational Model: Cohort, Time Perspective: Prospective
Asher Salmon, M.D.
Hadassah Medical Organization
Israel: Ministry of Health