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

Clin Gastroenterol Hepatol. 2006 Nov;4(11):1358-65. doi: 10.1016/j.cgh.2006.07.015. Epub 2006 Sep 25.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

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


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