Faecal dimeric M2 pyruvate kinase in colorectal cancer and polyps correlates with tumour staging and surgical intervention

Authors: Koss, K.1; Maxton, D.2; Jankowski, J. A. Z.

Source: Colorectal Disease, Volume 10, Number 3, March 2008 , pp. 244-248(5)

Publisher: Blackwell Publishing

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Abstract:

Objective & Method 

A dimeric form of pyruvate kinase isoenzyme (tumour M2-PK) is predominantly found in highly proliferating cells. Sandwich ELISA with monoclonal antibodies against dimeric (tumour) M2-PK was used to measure faecal tumour M2-PK in; 13 controls, 10 patients with colonic polyps and 32 patients with colorectal cancer. Results 

Levels of faecal tumour M2-PK were higher in patients with colorectal cancer (median 11.72 U/ml; range 0.9-146.95 U/ml, P = 0.0001) and polyps greater than 10 mm (median 2.54 U/ml; range 0.9-29.46 U/ml, P = 0.041) when compared with controls (median 1.75 U/ml; range 0.9-3.41 U/ml). Furthermore, levels were higher in stages Duke's B (P = 0.013) and Duke's C (P = 0.43) than in Duke's A. Six months postsurgery faecal tumour M2-PK levels fell significantly to 3.46 U/ml (range 1.03-9.05 U/ml, P = 0.001). The sensitivity of a positive faecal tumour M2-PK test, defined as a level above 3.33 U/ml, was 91% for colorectal cancer, 60% for >10 mm and 20% for <10 mm polyps, with a specificity of 92%. Conclusion 

Faecal tumour M2-PK is a highly sensitive marker for colorectal cancer and larger polyps. It also correlates with more advanced stages of colorectal cancer and its reduction is associated with successful surgical intervention.

Keywords: Faecal; M2-PK; pyruvate kinase; colorectal cancer; polyps; screening

Document Type: Research article

DOI: 10.1111/j.1463-1318.2007.01334.x

Affiliations: 1: Gastroenterology Department, Macclesfield District General Hospital, Maccelsfield 2: Gastroenterology Department, Royal Shrewsbury Hospital, Shrewsbury

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