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Meta-Analysis
. 2012 Aug 14;18(30):4004-11.
doi: 10.3748/wjg.v18.i30.4004.

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

Carolin Tonus  1 , Markus Sellinger, Konrad Koss, Gero Neupert
Affiliations
Meta-Analysis

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

Carolin Tonus et al. World J Gastroenterol. .

Abstract

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 guaiac-based faecal occult blood test (gFOBT). Faecal M2-PK 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 non-bleeding tumors and adenoma with high sensitivity and specificity.

Keywords: Adenoma; Colorectal cancer; Colorectal cancer screening; Faecal occult blood; Faecal pyruvate kinase isoenzyme type M2; Polyps; Stool.

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Figures

Figure 1
Figure 1
Faecal pyruvate kinase isoenzyme type M2 in healthy controls, patients with colorectal adenoma and colorectal cancer[51]. Faecal M2-PK: Faecal pyruvate kinase isoenzyme type M2.
Figure 2
Figure 2
Distribution of faecal pyruvate kinase isoenzyme type M2 concentrations in a screening collective of 2787 participants aged from 45 to 65 years[52]. n: Number of test negative; N: Total number of subjects; M2-PK: Pyruvate kinase isoenzyme type M2.
Figure 3
Figure 3
Percentage of faecal pyruvate kinase isoenzyme type M2-positive volunteers by age group (from Tonus et al[49]).
See this image and copyright information in PMC

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