M2-PK (EDTA) and Calprotectin
May 29, 2012 | 30,00 EUR | answered by Dr. med. Hendrik Bernau
Dear Sir or Madam,
At the end of November 2011, I had severe abdominal pain (on the left side under the rib cage), which I had experienced before in 2007 and 2009. Due to my hypochondriac tendencies, I immediately had various tests done.
CA 19-9 OK
Cyfra 21-1 OK
CA 72-4 OK
CEA OK
NSE OK
ProGRP OK
SCC OK
LDH 146
M2-PK (EDTA) at 22.4 (too HIGH).
Following this, I underwent an endoscopy, colonoscopy, MRT+MRCP, and 4 ultrasounds. The abdominal pain disappeared! I then simply waited until the end of April 2012 (almost 5 months later).
Now all values are OK again except for M2-PK, which is now at 24.1. Slightly increased.
I have now returned to the gastroenterologist and urologist. Kidneys OK. Abdominal ultrasound OK. Kidney ultrasound OK. All other tumor markers OK. Chest X-ray OK.
Yesterday, I received a positive stool test with Calprotectin (value at 115). TOO HIGH. A M2-PK test in the stool last week came back negative.
Do I have colon cancer now? Stomach cancer? Pancreatic cancer?
Dear questioner,
You describe recurring abdominal pain over the past two years. Additionally, you have included test results (including tumor markers, colonoscopy, blood tests). After the gastric endoscopy/ultrasound series, your abdominal pain disappeared and your values normalized, except for the tumor marker Pyruvate Kinase M2.
This enzyme is only found in fetal and tumor tissue, which makes the marker very reliable (with a sensitivity between 78% and 97%). Unfortunately, despite its high sensitivity, this marker is not organ-specific; rather, it reflects the metabolic state of the tumor.
The elevated level of Calprotectin is initially just a sign of leukocytes, in this case in the intestine, indicating inflammatory processes. These could have a cause other than carcinoma.
You now have 2 abnormal values that do not yet indicate a tumor diagnosis. You should not burden yourself with negative thoughts, but it is important to investigate the cause of the abnormal values. So, the specific answer to your question is: No, you do not have a cancer diagnosis based on the abnormal values, but you should further investigate with your primary care physician.
I hope I have been able to help you. If you have any further questions, I am available at any time.
Wishing you good health.
Best regards,
Dr. med. - anonymized -
