title: Colorectal cancer screening by non-invasive metabolic biomarker fecal tumor M2-PK.
abstract: OBJECTIVE
  To evaluate the utility of the innovative fecal tumor M2-Pyruvate kinase (M2-PK) test in our daily clinical routine, as a marker for the pre-selection of patients who should subsequently undergo colonoscopy for the diagnosis or exclusion of colorectal cancer.
  
  
  METHODS
  Fecal tumor M2-PK was measured in stool samples of 96 study participants (33 patients with colorectal cancer, 21 patients with rectal carcinoma and 42 controls) who all underwent total colonoscopy.
  
  
  RESULTS
  In 39 of 42 individuals in the control group, fecal tumor M2-PK was below 4.0 kU/L (93% specificity). Colorectal tumors were accompanied by a highly significant increase (P < 0.001) in fecal tumor M2-PK levels (median: colon carcinoma, 23.1 kU/L; rectal carcinoma, 6.9 kU/L; colorectal carcinoma, 14.7 kU/L), which correlated with Duke's staging and T-classification. The overall sensitivity was 78% for colorectal cancer, increasing from 60% for stage T1 to 100% for stage T4 and from 60% for Duke's A to 90% for Duke's D tumors.
  
  
  CONCLUSIONS
  Fecal tumor M2-PK is an appropriately sensitive tool to pre-select those patients requiring colonoscopy for the further diagnostic confirmation or exclusion of colorectal cancer.
authors.affiliation: Herz-Jesu-Hospital, Surgical Clinic, Buttlarstr. 74, Fulda 36039, Germany. c.tonus@herz-jesu-krankenhaus.de
authors.forename: Carolin
authors.initials: C
authors.lastname: Tonus
authors.forename: Gero
authors.initials: G
authors.lastname: Neupert
authors.forename: Markus
authors.initials: M
authors.lastname: Sellinger
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000378:metabolism; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000201:enzymology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011770:Pyruvate Kinase / Q000032:analysis* / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D011770:Pyruvate Kinase