胃癌是我国发病率与死亡率均位居前列的恶性肿瘤,5 年生存率低,胃癌治疗主要以手术联合放化疗为主。 由于 胃癌早期症状不明显,且目前传统的肿瘤标志物敏感度和特异度有限,早期胃癌患者诊断困难。 因此,早期胃癌的诊断途径, 胃癌治疗的靶点以及有效的预后评估方法成为热点。 近年来,肿瘤细胞能量代谢过程中的关键酶受到了更多的关注。 丙酮 酸激酶 M2(PKM2)是细胞糖酵解中的关键酶,在肿瘤组织、血清及其他体液中表达异常,不仅参与了肿瘤细胞的营养代谢,还 参与丝裂活化蛋白酶(MAPK)的转录、磷脂酰肌醇-3 激酶/ 蛋白激酶 B/ 雷帕霉素靶蛋白(PI3K/ Akt / mTOR)信号通路以及 NFκB/ miR-148a / 152 反馈环等多个过程,并通过上述反应促进了胃癌细胞的增殖、侵袭、转移以及血管肿瘤的生成,并抑制了胃 癌细胞的凋亡。 PKM2 可用于胃癌早期诊断、治疗及预后评估。 本文对近年来 PKM2 在胃癌的早期诊断、治疗与预后评估的 相关研究进行综述,为提高诊断的敏感度和特异度、研发新的治疗策略和预后评估提供一定的价值。

Gastric cancer is a malignant tumor with the highest incidence and mortality rate and low 5-year survival rate in China. Treatment of gastric cancer is mainly surgery combined with radiation and chemotherapy. Due to the inconspicuous early symptoms of gastric cancer and the limited sensitivity and specificity of the current traditional tumor markers it is difficult to diagnose patients with early gastric cancer in China. Therefore the diagnostic pathways of early gastric cancer the targets of gastric cancer treatment and effective prognostic assessment methods have been major concerns. In recent years key enzymes in the energy metabolism of tumor cells have received more attention. Pyruvate kinase M2 PKM2 a key enzyme in the glycolytic pathway is abnormally expressed in tumor tissues serum and other body fluids and is involved not only in the nutrient metabolism of tumor cells but also in mitogenic activation. It is not only involved in the transcription of MAPK but also related to phosphatidylinositol-3-kinase PI3K / protein kinase B/ the mammalian target of tapamycin mTOR PI3K/ Akt / mTOR signaling pathway and NF-κB/ miR-148a / 152 feedback loop and other processes and through the above responses promote the proliferation invasion metastasis and vascular tumorigenesis of gastric cancer cells and inhibit apoptosis of gastric cancer cells. Recent researches have shown that PKM2 can be used for early diagnosis treatment and prognosis assessment of gastric cancer. This study reviews researches about early diagnosis treatment and prognosis assessment of PKM2 in gastric cancer in recent years which provide insight for improving the sensitivity and specificity of diagnosis developing new treatment strategies and prognosis assessment.