Urine PGE-M: A metabolite of prostaglandin E2 as a potential biomarker of advanced colorectal neoplasia.

Abstract

BACKGROUND & AIMS:

The enzyme cyclooxygenase-2 is expressed in a majority of colorectal carcinomas (CRCs) and is important in prostaglandin production. We have developed an accurate method to measure the urinary metabolite of prostaglandin E(2) (PGE-M) using recently developed mass spectrometric techniques. The purpose of this pre-validation study was to determine if urinary PGE-M levels can be used as a biomarker to discriminate between healthy patients and those with colorectal disease.

METHODS:

Urine PGE-M was assessed in a total of 228 patients with CRC, colonic adenomatous polyps, Crohn's disease, and in subjects with no endoscopically detectable disease. Thirteen rectal carcinoma patients were treated with celecoxib and urinary PGE-M was measured before and after treatment.

RESULTS:

Urine PGE-M levels were increased among healthy men compared with healthy women (median, 8.59 [interquartile range (IQR), 5.67-22.3] vs 4.25 [IQR, 2.35-6.03], P = .0027). Urine PGE-M levels among patients with Crohn's disease (median, 19.85 [IQR, 6.89-90.2]), CRC (median, 14.65 [IQR, 5.94-92.1]), or large adenomas greater than 1 cm in size (median, 18.85 [IQR, 11.9-25.6]) were significantly increased when compared with patients who had either small polyps less than 1 cm in size (median, 9.69 [IQR, 6.41-22.2]), or no polyps (median, 7.05 [IQR, 2.35-24.7]) (P = .0001). PGE-M levels decreased significantly after celecoxib treatment in patients with rectal cancer (median, 21.7 [IQR, 16.2-29.9] vs 9.14 [IQR, 7.14-13.2], P = .009).

CONCLUSIONS:

The increase in urinary PGE-M in patients with colorectal cancers and large adenomas suggests that urinary PGE-M is a potentially useful biomarker for the detection of advanced colorectal neoplasia.

• Authors: J Chad Johnson, Carl R Schmidt, Martha J Shrubsole, D Dean Billheimer, Prashant R Joshi, Jason D Morrow, Martin J Heslin, M Kay Washington, Reid M Ness, Wei Zheng, David A Schwartz, Robert J Coffey, R Daniel Beauchamp, Nipun B Merchant
• Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (Clin Gastroenterol Hepatol) Vol. 4 Issue 11 Pg. 1358-65 (Nov 2006) ISSN: 1542-3565 [Print] United States
• PMID: 16996805 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Biomarkers, Tumor
• Prostaglandins
• 7-hydroxy-5,11-dioxotetranorprostane-1,16-dioic acid
• Cyclooxygenase 2

Topics

• Adenoma (diagnosis)
• Aged
• Biomarkers, Tumor
• Colonic Polyps (diagnosis)
• Colorectal Neoplasms (diagnosis)
• Crohn Disease (diagnosis, urine)
• Cyclooxygenase 2 (metabolism)
• Female
• Humans
• Immunohistochemistry
• Logistic Models
• Male
• Middle Aged
• Prostaglandins (urine)
• Sensitivity and Specificity