Pyruvate Kinase M2 Expression: A Potential Metabolic Biomarker to Differentiate Endometrial Precancer and Cancer that is Associated with Poor Outcomes in Endometrial Carcinoma

Yu-Ju Lai, Yu-Ching Chou, Yi-Jia Lin, Mu-Hsien Yu, Yu-Che Ou, Po-Wei Chu, Chia-Chun Wu, Yu-Chi Wang and Tai-Kuang Chao
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Yu-Ju Lai: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yu-Ching Chou: School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
Yi-Jia Lin: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Mu-Hsien Yu: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yu-Che Ou: Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital, Chiayi 600, Taiwan
Po-Wei Chu: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Chia-Chun Wu: Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Yu-Chi Wang: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
Tai-Kuang Chao: Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan

IJERPH, 2019, vol. 16, issue 23, 1-10

Abstract: Background: Pyruvate kinase M2 (PKM2) is a regulator of the processes of glycolysis and oxidative phosphorylation, but the roles that it plays in endometrial cancer remain largely unknown. This study evaluated the PKM2 expression in normal endometrium, endometrial hyperplasia, and endometrial carcinoma, and its prognostic value was investigated in endometrial carcinoma patients. Methods: A hospital-based retrospective review was conducted to examine the immunohistochemical PKM2 distribution in 206 endometrium samples from biopsies or hysterectomies. The immunoreactivity of PKM2 was divided into groups of low and high scores according to the extent and intensity of staining. Results: Intense cytoplasmic staining was observed for the PKM2 protein in malignant endometrial lesions. A high PKM2 score was observed in many endometrial carcinoma samples (50.0%), but there was a low percentage in endometrial atypical hyperplasia (12.5%). High PKM2 expression was not found in the normal endometrium (0.0%) nor endometrial hyperplasia without atypia (0.0%). The PKM2 protein score was significantly higher in endometrial carcinoma samples than premalignant endometrial lesions ( p < 0.001). Notably, higher PKM2 scores in cases of endometrial carcinoma correlated with poor overall survival ( p = 0.006), and the hazard ratio for death was 3.40 (95% confidence interval, 1.35–8.56). Conclusions: Our results indicate that the prevalence of PKM2 high tumor cells in endometrial carcinoma is significantly associated with worse prognostic factors and favors a poor prognosis. The expression of PKM2 is also a potential histopathological biomarker for use in the differential diagnosis of malignant and premalignant endometrial lesions.

Keywords: pyruvate kinase M2; endometrial hyperplasia; endometrial carcinoma (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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