A combination of faecal tests for the detection of colon cancer

Abstract

The combination of i-FOBT and M2-PK is a sensitive tool in clinical practice for the appropriate management of waiting lists for colonoscopy, as it allows the classification of patients into different degrees of priority for investigation, according to their foreseeable risk of CRC.

Ellipsometry Analytical Complex for Measuring near the Surface Plasmon Resonance in Colorectal Cancer Diagnosis

“…The difference in the serum level of tumor M2-PK between patients with CRC and healthy individuals was determined with a sensitivity of 98%, which was consistent with the results of the study [26] and exceeded the sensitivity of such methods as colonoscopy, occult fecal blood tests, levels of cancer-embryonic antigen, and the fecal M2-PK [27,28]. In the routine laboratory practice, the fecal M2-PK is determined using monoclonal antibodies specific to the dimeric form (immuno-enzyme analysis).…”

Faecal immunochemical tests to triage patients with lower abdominal symptoms for suspected colorectal cancer referrals in primary care: a systematic review and cost-effectiveness analysis

“…The sensitivity and specificity estimates for faecal immunochemical testing alone and CRC were 61.7% (95% CI 47.4% to 74.2%) and 88.8% (95% CI 84.1% to 92.3%), respectively; for the combination of faecal immunochemical testing and faecal calprotectin these estimates were 90.9% (95% CI 78.8% to 96.4%) and 35.9% (95% CI 29.7% to 42.6%), respectively; for faecal immunochemical testing and M2-PK, sensitivity and specificity were 91.5% (95% CI 80.1% to 96.6%) and 57.1% (95% CI 50.6% to 63.2%), respectively, and, for all of the three markers, they were 95.7% (85.7% to 98.8%) and 24.1% (18.8% to 30.2%), respectively. 142 Although all of the sensitivity estimates were generally lower, this pattern was repeated when the target condition was advanced neoplasia. 142 However, the FIT threshold in this study (20 µg Hb/g faeces) was higher than that which the results of our systematic review indicate is likely to be the optimal threshold (10 µg Hb/g faeces or a lower threshold).…”

“…142 Although all of the sensitivity estimates were generally lower, this pattern was repeated when the target condition was advanced neoplasia. 142 However, the FIT threshold in this study (20 µg Hb/g faeces) was higher than that which the results of our systematic review indicate is likely to be the optimal threshold (10 µg Hb/g faeces or a lower threshold). A second study 143 of accuracy for the target condition of advanced neoplasia, which did not meet the inclusion criteria for this assessment because it used a qualitative FIT method, also found that combining faecal calprotectin with faecal immunochemical testing (where a positive result was defined as either or both tests positive) resulted in increased sensitivity and decreased specificity [92% (95% CI 82% to 97%) and 49% (95% CI 43% to 54%)] compared with faecal immunochemical testing alone [74% (95% CI 62% to 83%) and 82% (95% CI 78% to 86%)].…”

“…Faecal calprotectin is an inflammatory marker, whereas M2-PK is a key enzyme in tumour metabolism. 142 This study 142 found that, in all cases, the addition of at least one further test to faecal immunochemical testing resulted in markedly increased sensitivity and decreased specificity. The sensitivity and specificity estimates for faecal immunochemical testing alone and CRC were 61.7% (95% CI 47.4% to 74.2%) and 88.8% (95% CI 84.1% to 92.3%), respectively; for the combination of faecal immunochemical testing and faecal calprotectin these estimates were 90.9% (95% CI 78.8% to 96.4%) and 35.9% (95% CI 29.7% to 42.6%), respectively; for faecal immunochemical testing and M2-PK, sensitivity and specificity were 91.5% (95% CI 80.1% to 96.6%) and 57.1% (95% CI 50.6% to 63.2%), respectively, and, for all of the three markers, they were 95.7% (85.7% to 98.8%) and 24.1% (18.8% to 30.2%), respectively.…”

“…However, we identified one study 142 that did not meet the inclusion criteria for our systematic review because it used an obsolete FIT assay, but that reported data on the performance characteristics of faecal immunochemical testing in combination with faecal calprotectin, M2-PK or both (for which a positive result was defined as at least one test being positive) for the target conditions of CRC and HRA, as well as data on the performance characteristics of faecal immunochemical testing alone. Faecal calprotectin is an inflammatory marker, whereas M2-PK is a key enzyme in tumour metabolism.…”