Expression of glycolytic enzymes (GLUT1, HK2, PKM2, LDH-A) and their association with tumour stage and clinicopathological characteristics in breast cancer patients
- 1Department of Medical Chemistry, College of Medicine, University of Al-Qadisiyah, Diwaniyah, Iraq
Abstract
Objective: Cancer cells reprogramme their metabolism toward aerobic glycolysis (Warburg effect), a process driven by key enzymes and transporters. This study evaluated serum levels of glucose transporter 1 (GLUT1), hexokinase 2 (HK2), pyruvate kinase M2 (PKM2), and lactate dehydrogenase A (LDH-A) in breast cancer patients before and after chemotherapy, and assessed their diagnostic performance.
Methods: A case–control study enrolled 120 women (30 untreated breast cancer, 30 post‑chemotherapy, and 60 age‑matched healthy controls) in Thi‑Qar, Iraq. Serum biomarkers were quantified using enzyme‑linked immunosorbent assays. Fasting blood glucose and lactate were measured enzymatically. Statistical analyses included ANOVA with Tukey’s post hoc test, Pearson correlation, receiver operating characteristic (ROC) curves, and Cohen’s d effect size. In silico validation used TCGA and GEO datasets.
Results: Pre‑treatment patients showed significantly elevated lactate, FBS, LDH‑A, GLUT1, and PKM2 compared with post‑treatment and control groups (p < 0.001). Post‑chemotherapy levels decreased but remained above controls for most markers except HK2, which was unexpectedly higher in controls. PKM2 and LDH‑A demonstrated excellent diagnostic accuracy (AUCs of 0.98 and 0.97, respectively). Correlation analysis revealed a positive association between PKM2 and FBS (r = 0.572, p = 0.001). Effect sizes were large for LDH‑A and PKM2.
Conclusion: Serum PKM2 and LDH‑A are promising non‑invasive diagnostic biomarkers for breast cancer and may help monitor treatment response, despite the unexpected behaviour of HK2, which warrants further investigation.
Related
- Immunohistochemical Expression of M30, BCL-2, BAX, and Ki-67 in Pancreatic Ductal Adenocarcinoma: Association with Clinicopathological Features
- Association of VCP/p97 Expression with Clinicopathological Features and Overall Survival in Endometrioid Endometrial Carcinoma
- Expression of phospho-S6 and its correlation with clinicopathological characteristics in retroperitoneal extravisceral perivascular epithelioid cell tumors
- Association of phenotypic and functional characteristics of regulatory T cells from minor salivary glands with expression of the delta 7 FoxP3 splice variant in patients with Sjögren’s disease
- Expression, association with clinicopathological features and prognostic potential of FOXR2, mTOR, HIF−1α and PKM2 in high−grade serous carcinoma of the ovary
BibTeX
@article{alsaeedi2026expression,
title = {{Expression of glycolytic enzymes (GLUT1, HK2, PKM2, LDH-A) and their association with tumour stage and clinicopathological characteristics in breast cancer patients}},
author = {Entidhar Al-Saeedi and Ahmed Al-Ziaydi},
journal = {Babcock University Medical Journal},
year = {2026},
month = oct,
doi = {10.38029/babcockuniv.med.j..v9is1.1639},
url = {https://doi.org/10.38029/babcockuniv.med.j..v9is1.1639},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Expression of glycolytic enzymes (GLUT1, HK2, PKM2, LDH-A) and their association with tumour stage and clinicopathological characteristics in breast cancer patients
AU - Entidhar Al-Saeedi
AU - Ahmed Al-Ziaydi
PY - 2026
DA - 2026/10/01
JO - Babcock University Medical Journal
DO - 10.38029/babcockuniv.med.j..v9is1.1639
UR - https://doi.org/10.38029/babcockuniv.med.j..v9is1.1639
AB - Objective: Cancer cells reprogramme their metabolism toward aerobic glycolysis (Warburg effect), a process driven by key enzymes and transporters. This study evaluated serum levels of glucose transporter 1 (GLUT1), hexokinase 2 (HK2), pyruvate kinase M2 (PKM2), and lactate dehydrogenase A (LDH-A) in breast cancer patients before and after chemotherapy, and assessed their diagnostic performance. Methods: A case–control study enrolled 120 women (30 untreated breast cancer, 30 post‑chemotherapy, and 60 age‑matched healthy controls) in Thi‑Qar, Iraq. Serum biomarkers were quantified using enzyme‑linked immunosorbent assays. Fasting blood glucose and lactate were measured enzymatically. Statistical analyses included ANOVA with Tukey’s post hoc test, Pearson correlation, receiver operating characteristic (ROC) curves, and Cohen’s d effect size. In silico validation used TCGA and GEO datasets. Results: Pre‑treatment patients showed significantly elevated lactate, FBS, LDH‑A, GLUT1, and PKM2 compared with post‑treatment and control groups (p < 0.001). Post‑chemotherapy levels decreased but remained above controls for most markers except HK2, which was unexpectedly higher in controls. PKM2 and LDH‑A demonstrated excellent diagnostic accuracy (AUCs of 0.98 and 0.97, respectively). Correlation analysis revealed a positive association between PKM2 and FBS (r = 0.572, p = 0.001). Effect sizes were large for LDH‑A and PKM2. Conclusion: Serum PKM2 and LDH‑A are promising non‑invasive diagnostic biomarkers for breast cancer and may help monitor treatment response, despite the unexpected behaviour of HK2, which warrants further investigation.
SN - 2465-6666
SN - 2756-4657
ER -