Faecal pyruvate kinase isoenzyme type M2 for colorectal cancer screening：A meta-analysis

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 30; pp. 4004 - 4011
• Main Author: Tonus, Carolin
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 14.08.2012
• Subjects: Adenoma - diagnosis; Adenoma - pathology; Brief; Carcinoma - diagnosis; Carcinoma - pathology; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Early Detection of Cancer - methods; Feces - enzymology; Humans; M2型; Meta分析; Pyruvate Kinase - analysis; Sensitivity and Specificity; 丙酮酸激酶; 大肠; 筛检; 粪便污染; 结直肠癌; 酶同工酶; Faecal pyruvate kinase isoenzyme type M2; Stool; Colorectal cancer; Colorectal cancer screening; Adenoma; Faecal occult blood; Polyps
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v18.i30.4004

AIM：To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2（faecal M2-PK） test for colorectal cancer（CRC） screening based on the currently available studies.METHODS：A literature search in PubMed and Embase was conducted using the following search terms：fecal Tumor M2-PK,faecal Tumour M2-PK,fecal M2-PK,faecal M2-PK,fecal pyruvate kinase,faecal pyruvate kinase,pyruvate kinase stool and M2-PK stool.RESULTS：Stool samples from 704 patients with CRC and from 11 412 healthy subjects have been investigated for faecal M2-PK concentrations in seventeen independent studies.The mean faecal M2-PK sensitivity was 80.3%;the specificity was 95.2%.Four studies compared faecal M2-PK head-to-head with guaiacbased faecal occult blood test（gFOBT）.Faecal M2PK demonstrated a sensitivity of 81.1%,whereas the gFOBT detected only 36.9% of the CRCs.Eight independent studies investigated the sensitivity of faecal M2-PK for adenoma（n = 554）,with the following sensitivities：adenoma 〈 1 cm in diameter：25%;adenoma 〉 1 cm：44%;adenoma of unspecified diameter：51%.In a direct comparison with gFOBT of adenoma 〉 1 cm in diameter,47% tested positive with the faecal M2-PK test,whereas the gFOBT detected only 27%.CONCLUSION：We recommend faecal M2-PK as a routine test for CRC screening.Faecal M2-PK closes a gap in clinical practice because it detects bleeding and nonbleeding tumors and adenoma with high sensitivity and specificity.