Abstract
Pyruvate kinase M2 (PKM2) is the key enzyme in the Warburg effect and plays a central role in cancer cell metabolic reprogramming. Recently, quite a few studies have investigated the correlation between PKM2 expression and prognosis in multiple cancer patients, but results were inconsistent. We therefore performed a meta-analysis to explore the prognostic value of PKM2 expression in patients with solid cancer. Here twenty-seven individual studies from 25 publications with a total of 4796 cases were included to explore the association between PKM2 and overall survival (OS) or disease-free survival (DFS)/ progression-free survival (PFS)/ recurrent-free survival (RFS) in subjects with solid cancer. Pooled analysis showed that high levels of PKM2 was significantly associated with a poorer overall survival (HR = 1.73; 95%CI = 1.48-2.03) and DFS/ PFS/ RFS (HR = 1.90; 95%CI = 1.39-2.59) irrespective of cancer types. Different analysis models (univariate or multivariate models), sample-sizes (≤100 or >100), and methods for data collection (direct extraction or indirect extraction) had no impact on the negative prognostic effect of PKM2 over-expression. Nevertheless, stratified by cancer type, high-expression of PKM2 was associated with an unfavorable OS in breast cancer, esophageal squamous carcinoma, hepatocellular carcinoma and gallbladder cancer; whereas was not correlated with a worse OS in pancreatic cancer and gastric cancer. In conclusion, over-expression of PKM2 is associated with poor prognosis in most solid cancers and it might be a potentially useful biomarker for predicting cancer prognosis in future clinical applications.
Highlights
As it is known that cancer has been a major cause of death in both developed and underdeveloped countries; the jeopardy is estimated to grow worldwide due to the increase and aging of the population, as well as a growing prevalence of established risk factors such as smoking, obesity, lack of exercise, and so on [1]
Enhanced expression of Pyruvate kinase M2 (PKM2) has been reported in multiple cancers including gastric cancers [5, 6], hepatocellular carcinoma [7], esophageal squamous cell carcinoma [8, 9], colorectal cancer [10], and gallbladder cancer [11]
The results of our meta-analysis suggest that over-expression of PKM2, which indicates a higher rate of glycolysis in tumor cells, is associated with an unfavorable prognosis and is a potential biomarker associated with overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS)/recurrent-free survival (RFS) in patients with solid tumors
Summary
As it is known that cancer has been a major cause of death in both developed and underdeveloped countries; the jeopardy is estimated to grow worldwide due to the increase and aging of the population, as well as a growing prevalence of established risk factors such as smoking, obesity, lack of exercise, and so on [1]. According to GLOBOCAN estimates, approximately 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide [1]. Enhanced expression of PKM2 has been reported in multiple cancers including gastric cancers [5, 6], hepatocellular carcinoma [7], esophageal squamous cell carcinoma [8, 9], colorectal cancer [10], and gallbladder cancer [11]. More recently, quite a few studies have investigated the correlation between the expression of PKM2 and prognosis among multiple cancer patients. Benesch et al [15] reported that strong PKM2 expression indicated a favorable outcome for breast cancer patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
