title: The value of fecal tumor M2 pyruvate kinase as a diagnostic tool for colorectal cancer screening.
abstract: OBJECTIVE
  to evaluate the performance of fecal tumor M2 pyruvate kinase (M2PK) as a diagnostic biomarker for colorectal cancer (CRC) screening in high-risk or symptomatic populations.
  
  
  METHODS
  consecutive patients (N=328) who were referred for elective colonoscopy were prospectively enrolled. One walnut-sized stool sample was collected from each patient for analysis of tumor M2PK content using an ELISA kit. No dietary restrictions were applied. The clinical pathologists who conducted the M2PK analyses were blinded to the patients' confirmed diagnoses. Levels of fecal tumor M2PK were compared with histopathological results from colorectal biopsies.
  
  
  RESULTS
  of the 328 patients who underwent colonoscopy examinations, 197 (60.1%) were men and 131 (39.9%) were women. Based on histopathological examination, 83 (25.3%) patients had normal bowel histology, 42 (12.8%) patients had CRC, 67 (20.4%) patients had adenoma, 19 (5.8%) patients had inflammatory bowel disease, three (0.9%) patients had amoebic colitis, and 114 (34.8%) patients had infective colitis. The cutoff level for tumor M2PK concentration was defined as 4.00 U/mL. The sensitivity, specificity, positive predictive value, and negative predictive value of the M2PK test were 71.4%, 71.0%, 73.5%, and 94.4%, respectively. There was a significant association between CRC and fecal tumor M2PK level (P<0.001). The M2PK test detected 16 tumors among 67 (23.9%) cases of adenoma, eight tumors among 19 (42.1%) cases of inflammatory bowel disease, 35 tumors among 114 (30.7%) cases of infective colitis, and two tumors among three (66.7%) cases of amoebic colitis.
  
  
  CONCLUSIONS
  the fecal tumor M2PK test has good sensitivity and specificity for CRC detection, especially in high-risk or symptomatic populations.
authors: Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital. Jl. Diponegoro no. 71, Jakarta 10430, Indonesia. murdani.abdullah@ui.ac.id
authors: Murdhani
authors: M
authors: Abdullah
authors: Abdul A
authors: AA
authors: Rani
authors: Marcellus
authors: M
authors: Simadibrata
authors: Ahmad
authors: A
authors: Fauzi
authors: Ari F
authors: AF
authors: Syam
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004404:Dysentery, Amebic / Q000175:diagnosis; D055088:Early Detection of Cancer; D005243:Feces / Q000201:enzymology*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011770:Pyruvate Kinase / Q000378:metabolism*; D012372:ROC Curve; D016037:Single-Blind Method
chemical_list: D014408:Biomarkers, Tumor; D011770:Pyruvate Kinase