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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 21, 2006; 12(43): 7007-7011
Published online Nov 21, 2006. doi: 10.3748/wjg.v12.i43.7007
Colorectal cancer screening by non-invasive metabolic biomarker fecal tumor M2-PK
Carolin Tonus, Gero Neupert, Markus Sellinger
Carolin Tonus, Herz-Jesu-Hospital, Surgical Clinic, Buttlarstr. 74, Fulda 36039, Germany
Gero Neupert, Offenbach Municipal Hospital, Surgical Clinic, Starkenburgring 66, Offenbach 63069, Germany
Markus Sellinger, Medical Practice for Gastroenterology and Hepatology, Rheingönheimer Str. 121, Ludwigshafen 67065, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Carolin Tonus, Herz-Jesu-Hospital, Surgical Clinic, Buttlarstr. 74, Fulda 36039, Germany. c.tonus@herz-jesu-krankenhaus.de
Telephone: +49-661-15321  Fax: +49-661-15324
Received: May 30, 2006
Revised: October 2, 2006
Accepted: October 9, 2006
Published online: November 21, 2006

AIM: 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.

CONCLUSION: 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.

Keywords: Tumor M2-Pyruvate kinase, Pyruvate kinase type M2, Colon cancer, Rectal cancer, Adenoma, Feces, Cancer screening