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Accepted Articles of Congress

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  • Aerobic Glycolysis Gene Overexpression and Prognostic Value in Pancreatic Ductal Adenocarcinoma: A Systematic Review

  • Kimia Heydariyar,1,* Hori Ghaneialvar,2 Omid Raiesi,3 Alireza Vasiee,4
    1. Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
    2. Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
    3. Department of Parasitology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
    4. Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran


  • Introduction: Pancreatic ductal adenocarcinoma (PDAC) exhibits a pronounced Warburg effect, with upregulation of key glycolytic enzymes (GLUT1, HK2, PKM2, LDHA) driving tumor growth and metastasis. Although overexpression of these genes has been linked to aggressive clinicopathologic features, the aggregate impact on patient survival remains unclear. This review quantifies the prognostic significance of aerobic glycolysis–related gene overexpression in PDAC.
  • Methods: We searched PubMed, EMBASE, Web of Science, and Cochrane Library up to June 2025 for cohort studies reporting associations between PDAC tumor expression levels of GLUT1, HK2, PKM2, or LDHA and overall survival (OS) or disease-free survival (DFS). Two reviewers independently screened 1,742 records, extracted hazard ratios (HR) and 95% confidence intervals (CI), and assessed study quality using the Newcastle–Ottawa Scale.
  • Results: Twelve studies encompassing 3,450 PDAC patients (median follow-up 18.2 months) met inclusion criteria. High expression of individual glycolytic genes was observed in 62% of tumors (95% CI 58–66%). Pooled analysis demonstrated that glycolysis gene overexpression conferred a 75% increased risk of death (HR 1.75; 95% CI 1.52–2.02; p<0.01) and a 68% increased risk of recurrence (HR 1.68; 95% CI 1.42–1.98; p<0.05). A composite glycolytic gene signature (GLUT1 + HK2 + PKM2 + LDHA) identified a subgroup with over two-fold higher mortality (HR 2.30; 95% CI 1.85–2.86; p<0.02).
  • Conclusion: Overexpression of aerobic glycolysis genes in PDAC is associated with substantially worse survival and higher recurrence rates. These aggregated findings validate glycolytic enzyme expression as a prognostic biomarker and support development of targeted metabolic therapies in PDAC.
  • Keywords: pancreatic ductal adenocarcinoma; aerobic glycolysis; GLUT1; HK2

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