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Elevated creatine phosphokinase MB in a patient with neuroendocrine carcinoma of the colon—Evidence for a tumor marker

Report of a case

  • Published:
Diseases of the Colon & Rectum

Abstract

Elevated creatine phosphokinase (CPK) MB isoenzyme has become accepted as a highly specific criterion for the diagnosis of myocardial infarction (MI). A patient with metastatic neuroendocrine carcinoma of the colon who had marked and persistent elevation of CPK-MB isoenzyme, in the absence of clinical and cardiographic evidence for MI, is described. The CPK-MB level was 25 percent (normal, <3 percent) on admission, 39 percent postoperatively, and 57 percent on discharge. A prompt decline in serum CPK-MB activity (11 percent, <3 percent) paralleled chemotherapy-induced tumor regression. Resurgence of the isoenzyme heralded recurrent disease. These findings suggest that CPK-MB may be a valuable adjunct marker in the diagnosis and monitoring of neuroendocrine carcinomas.

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References

  1. Roberts R, Gowda KS, Ludbrook PA, Sobel BE. Specificity of elevated serum MB creatine phosphokinase activity in the diagnosis of acute myocardial infarction. Am J Cardiol 1975;36:433–7.

    Article  PubMed  CAS  Google Scholar 

  2. Day IN, Thompson RJ. Levels of immunoreactive aldolase C, creatine kinase-BB, neuronal and non-neuronal enolase, and 14-3-3 protein in circulating human blood cells. Clin Chim Acta 1984;136:219–28.

    Article  PubMed  CAS  Google Scholar 

  3. Tsung SH. Several conditions causing elevation of serum CK-MB and CK-BB. Am J Clin Pathol 1980;75:711–5.

    Google Scholar 

  4. Tsung SH, Huang TY, Han D, Loh WP. Total creatine kinase and isoenzyme MB activity in serum and skeletal muscle of a patient with dermatomyositis. Clin Chem 1980;26:1912–3.

    PubMed  CAS  Google Scholar 

  5. King DT, Fu PC, Wishon GM. Persistent creatine kinase MB isoenzyme without cardiac disease. Arch Pathol Lab Med 1978;102:481–2.

    PubMed  CAS  Google Scholar 

  6. Brownlow K, Elevitch FR. Serum creatine phosphokinase isoenzyme (CPK2) in myositis: a report of six cases. JAMA 1974;230: 1141–4.

    Article  PubMed  CAS  Google Scholar 

  7. Silverman LM, Mendell JR, Gruemer H-D. Creatine kinase isoenzymes in muscular dystrophy (abstract). Clin Chem 1974;20:865–6.

    Google Scholar 

  8. West M, Eshchar J, Zimmerman HJ. Serum enzymology in the diagnosis of myocardial infarction and related cardiovascular conditions. Med Clin North Am 1966;50:171–91.

    PubMed  CAS  Google Scholar 

  9. Wagner GS, Roe CR, Limbird LE, Rosati RA, Wallace AG. The importance of identification of the myocardial—specific isoenzyme of creatine phosphokinase (MB form) in the diagnosis of acute myocardial infarction. Circulation 1973;47:263–9.

    PubMed  CAS  Google Scholar 

  10. Smith AF. Diagnostic value of serum-creatine-kinase in a coronary-care unit. Lancet 1967;2:178–182.

    Article  PubMed  CAS  Google Scholar 

  11. Roberts R, Sobel BE. Isoenzymes of creatine phosphokinase and diagnosis of myocardial infarction. Ann Intern Med 1973;79: 741–3.

    PubMed  CAS  Google Scholar 

  12. Galen RS. The enzyme diagnosis of myocardial infarction. Hum Pathol 1975;6:141–55.

    Article  PubMed  CAS  Google Scholar 

  13. Rubery ED, Doran JF, Thompson RJ. Brain-type creatine kinase BB as a potential tumour marker—serum levels measured by radioimmunoassay in 1015 patients with histologically confirmed malignancies. Eur J Cancer Clin Oncol 1982;18:951–6.

    Article  PubMed  CAS  Google Scholar 

  14. Tsung SH. Total CK activity and isoenzyme patterns in normal and neoplastic tissue of gastrointestinal tract. J Clin Pathol 1982;35:204–6.

    PubMed  CAS  Google Scholar 

  15. Thompson RJ, Rubery ED, Jones HM. Radioimmunoassay of serum creatine kinase-BB as a tumor marker in breast cancer. Lancet 1980;1:673–5.

    Article  Google Scholar 

  16. Alexander RL Jr. Case report: changes in creatine kinase isoenzymes after myocardial infarction in a patient with prostatic carcinoma. Clin Chem 1980;26:661–3.

    PubMed  Google Scholar 

  17. Zweig MH, Van Streirteghem AC. Assessment by radioimmunoassay of serum creatine kinase BB (CK-BB) as a tumor marker: studies in patients with various cancers and a comparison of CK-BB concentrations to prostate acid phosphatase concentrations. J Natl Cancer Inst 1981;66:859–62.

    Google Scholar 

  18. Silverman LM, Dermer GB, Zweig MH, Van Steirteghem AC, Tökes ZA. Creatine kinase BB: a new tumor-associated marker. Clin Chem 1979;25:1432–5.

    PubMed  CAS  Google Scholar 

  19. Tsung SH. Creatine kinase activity and isoenzyme pattern in various normal tissues and neoplasms. Clin Chem 1983;29:2040–3.

    PubMed  CAS  Google Scholar 

  20. Goffman T, Cantrell J, Schein P. Unexplained increase in serum creatine kinase isoenzyme MB activity in a lung cancer patient. Clin Chem 1981;27:2068–9.

    PubMed  CAS  Google Scholar 

  21. Annesley TM, McKenna BJ. Ectopic creatine kinase MB production in metastatic cancer. Am J Clin Pathol 1983;79:255–9.

    PubMed  CAS  Google Scholar 

  22. Lee BI, Bach PM, Horton JD, Hickey TM, Davis WA. Elevated CK-MB and CK-BB in serum and tumor homogenate of a patient with lung cancer. Clin Cardiol 1985;8:233–6.

    Article  PubMed  CAS  Google Scholar 

  23. Szasz G, Gruber W, Bernt E. Creatine kinase in serum: I. Determination of optimum reaction conditions. Clin Chem 1976;22: 650–6.

    PubMed  CAS  Google Scholar 

  24. Beckman. Paragon CPK isoenzyme electrophoresis. Fullerton: Beckman Instruments, Inc., 1983.

    Google Scholar 

  25. Rosalki SB. An improved procedure for serum creatine phospho-kinase determination. J Lab Clin Med 1967;69:696–705.

    PubMed  CAS  Google Scholar 

  26. Elevitch FR, Brownlow K. A new fluorometric determination of serum creatine phosphokinase isoenzymes: detection of CPK-2 in myocardial infarction and fatal cardiovascular disorders. Am J Clin Pathol 1973;59:133–4.

    Google Scholar 

  27. Sternberger LA. The unlabeled antibody peroxidase-antiperoxidase (PA) method. In: Immunocytochemistry. 2nd ed. New York: Ed Wiley, 1979;104–69.

    Google Scholar 

  28. Warren WH, Memoli VA, Gould VE. Immunohistochemical and ultrastructural analysis of bronchopulmonary neuroendocrine neoplasms. I. Carcinoids. Ultrastruct Pathol 1984;6:15–27.

    PubMed  CAS  Google Scholar 

  29. Gould VE, Jao W, Chejfec G, Banner BF, Bonomi P. Neuroendocrine carcinomas of the gastrointestinal tract. Semin Diagn Pathol 1984;1:13–8.

    PubMed  CAS  Google Scholar 

  30. Livingston RB, Moore TN, Heibrun L, et al. Small cell carcinoma of the lung: combined chemotherapy and radiation. A Southwest Oncology Group study. Ann Intern Med 1978;88:194–9.

    PubMed  CAS  Google Scholar 

  31. Gould VE, Chejfec G. Ultrastructural and biochemical analysis of “undifferentiated” pulmonary carcinomas. Hum Pathol 1978;9: 377–84.

    Article  PubMed  CAS  Google Scholar 

  32. Ebie N, Bonomi P, Rossof A, et al. Neuroendocrine (“small cell”) carcinoma of the colon: clinical and pathologic features. Proc Am Soc Clin Oncol 1985;4:83.

    Google Scholar 

  33. Rowland K, Bonomi P, Taylor S IV, Maffey S, Reddy S, Lee MS. Continuous infusion VP-16, bolus cisplatin, and simultaneous radiation therapy as salvage therapy in small cell bronchogenic carcinoma (SCBC). Proc Am Soc Clin Oncol 1986;5:181.

    Google Scholar 

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Authors and Affiliations

  1. the Departments of General Surgery, Medical Oncology, Biochemistry, Cardiology, and Pathology, Rush Medical College and Presbyterian-St. Luke's Hospital, 1825 West Harrison Street, 60612, Chicago, Illinois

    Sherif L. Rizk M.D., David L. Roseman M.D., Philip Bonomi M.D., Howard Sky-Peck Ph.D., James Clark M.D., Inchul Lee M.D. & Victor E. Gould M.D.

Authors
  1. Sherif L. Rizk M.D.
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  2. David L. Roseman M.D.
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  3. Philip Bonomi M.D.
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  4. Howard Sky-Peck Ph.D.
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  5. James Clark M.D.
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  6. Inchul Lee M.D.
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  7. Victor E. Gould M.D.
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Supported in part by the Rayman Fund.

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Rizk, S.L., Roseman, D.L., Bonomi, P. et al. Elevated creatine phosphokinase MB in a patient with neuroendocrine carcinoma of the colon—Evidence for a tumor marker. Dis Colon Rectum 31, 318–322 (1988). https://doi.org/10.1007/BF02554370

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  • DOI: https://doi.org/10.1007/BF02554370

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